Comparative Study between Intravenous Ketamine and Magnesium Sulphate for Prevention of Shivering Post-Intrathecal Anesthesia

Document Type : Original Article

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Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Assiut, Egypt

Abstract

Background: Spinal anesthesia is recognized for its ability to greatly hinder the body's ability to regulate temperature. It does this by suppressing the body's natural vasomotor and shivering reflexes, as well as by moving heat away from the central part of the body to the peripheral tissues.
Aim: This study aimed to contrast the efficiency of intravenous ketamine against Magnesium sulphate added to 100 ml saline to prevent shivering associated with spinal anesthesia.
Methods: This is a prospective, randomized, double blinded controlled work. The present study was performed on 180 patients admitted to Al-Azhar University Hospitals, undergoing different elective procedures utilizing spinal anesthesia. Each participant was ASA physical status I and II.
Results: A statistically significant reduction in the frequency of shivering [grade II or greater] in the two groups, group K [23.3%] and group M [40%] contrasted to the frequency of 51% in the control group. Incidence of shivering was insignificantly different Immediately after spinal anesthesia, 5min, 10min,15min and 90 min and was substantially lower in group K in contrast to group M and group C and was significantly reduced in group M in contrast to group C [P value<0.05]. These results suggest that both Ketamine and Magnesium sulphate substantially decrease the frequency of shivering contrasted to the control group. And also, both delay the onset of shivering [if it happen] by a considerable amount.
Conclusion: Administering Ketamine at a dosage of 0.5 mg/kg, diluted in 100 ml of normal saline, over a 10minute period as a preventive measure is more effective compared to administering Magnesium sulphate at a dosage of 50 mg/kg, diluted in 100 ml of normal saline, over a period of 10 minutes in managing shivering after spinal anesthesia.

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