Could ephedrine replace meperidine for prevention of shivering in women undergoing Cesarean Section under spinal anesthesia? A randomized study

Purpose: To compare possible unlabeled effect of ephedrine, as shivering prophylaxis, with meperidine during spinal anesthesia for Cesarean Section. Methods: After institutional ethical committee approval, 96 parturients scheduled for elective cesarean delivery under spinal anesthesia were randomly allocated according to shivering prophylaxis to receive either 15 mg meperidine (group M, n = 48) or 6 mg ephedrine (group E, n = 48) intravenously before spinal block. Incidence and intensity of shivering as well as side effects of either drug were assessed. Results: The incidence shivering in meperidine and ephedrine groups in women undergoing Cesarean Section under spinal anesthesia was comparable (27%, 29% respectively, P = 0.06). Also, intensity of shivering was not different between two groups. Moreover, phenylephrine requirement and incidence of nausea and vomiting were significantly less in ephedrine group (121 +/- 2.2% and 4.1% respectively) relative to meperidine group (168 +/- 3.2% and 16.6% respectively). Conclusion: The prophylactic use of a low dose ephedrine is effective as meperidine for shivering prophylaxis in women undergoing Cesarean Section under spinal anesthesia as meperidine. Moreover, it is associated with less hypotension, nausea and vomiting. (C) 2012 Egyptian Society of Anesthesiologists. Production and hosting by Elsevier B.V. Open access under CC BY-NC-ND license.