ESRA Academy. Nasseri K. Sep 8, 2016; 138269; 0092 Topic: Adjuvant Drugs
Dr. Karim Nasseri
Dr. Karim Nasseri

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Background and Aims:

Shivering is among unpleasant and harmful side effects of spinal anesthesia especially in parturients. The aim of present study was to investigate whether intrathecal morphine (0.2 mg) decreases the incidence and intensity of shivering after spinal anesthesia for non-emergent cesarean section.


In this prospective randomized, double-blind, placebo-controlled trial 60 parturients categorized under the American Society of Anesthesiologists Physical  Status I and II Classification System, who have been  scheduled to undergo non-emergent cesarean section under spinal anesthesia were randomly designated into two groups to receive, ether heavy bupivacaine 0.5% (10 mg) for  group control (Group B), or heavy bupivacaine 0.5% (10 mg) plus morphine (0.2 mg) for  group study (Group M). Hemodynamic indices, axillary temperature, neonatal Apgar scores, incidence and intensity of shivering, and side effects were noted every 5 min during operation and every 30 min tell discharge from recovery room, by a blinded observer.


There were no statically significant differences between two groups regarding the demographic data, axillary temperatures, hemodynamic indices, and neonatal Apgar scores. The incidences of shivering were 76.6% (23/30) in group B, and 40% (12/30) in group M (P = 0.03). The intensity of shivering was less in the group M in compare to group B, too (P < 0.04). There were no significant differences in side effects between the two groups.


Low dose morphine (0.2 mg) added to spinal bupivacaine is effective in reducing the incidence and intensity of shivering in parturients undergoing spinal anesthesia for cesarean section.

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