Original Articles PROPHYLACTIC LOW DOSE KETAMINE IN PREVENTING PERIOPERATIVE SHIVERING DURING SPINAL ANESTHESIA IN ORTHOPEDIC PATIENTS: A PROSPECTIVE RANDOMIZED DOUBLE-BLIND STUDY

Abstract

Background:
After spinal anesthesia, shivering is reported to occur in 36 - 85 % of the cases. Physical techniques like external heating or pharmaceutical interventions are often used to avoid perioperative hypothermia and shivering. This study aimed to assess the effectiveness of low dose ketamine in preventing peri-operative shivering during spinal anesthesia in orthopedic patients.

Material and Methods:
This was a prospective randomized double-blinded study done at the Department of Anesthesia and Pain Management, The Indus Hospital, and Health Network Raiwind Campus Lahore for four months. 60 patients were incorporated. Group 1 patients (n=30) were given a low dose of ketamine (0.2 mg/kg iv) after spinal anesthesia while group 2 patients (n=30) were given 5ml of saline after spinal anesthesia. Axillary/frontal temperature was measured at 0, 15, and 30 minutes after spinal anesthesia.

Results:
In group 1, shivering was observed in 1 (3.33%), 1 (3.33%) and 3 (10%) patients after 0, 15 and 30 minutes respectively while in group 2, shivering was observed in 0 (00), 6 (20%) and 11 (36.67%) patients after 0, 15 and 30 minutes respectively (p=0.006). In group 1, rescue maneuver was used in 4 (13.33%) patients while group 2 rescue maneuver was used in 14 (46.67%) patients. This difference was statistically significant (p=0.005).

Conclusion:
Our study concludes that prophylactic Low dose ketamine is effective in preventing perioperative shivering during spinal anesthesia in orthopedic patients as compared to the placebo group.