Analysis Impact of two Diﬀerent Temperatures of 0.5% Heavy Bupivacaine on the Incidence of Shivering in Spinal Anaesthesia: A Comparative Study
Shivering in Spinal Anaesthesia
Background: In spinal anaesthesia profound nerve block can be produced in a large part of the body by injecting small amount of drug in subarachnoid space therefore less chances of drug toxicity by local anaesthetic. Injection of ice-cold epidural local anaesthetic increases shivering compared with epidural solutions that are pre-warmed to 30◦C. The present study was undertaken for assessing whether there is any effect of two different temperatures (4 ◦C and 37◦C) of 0.5% heavy bupivacaine on the incidence of shivering in spinal anaesthesia. Subjects and Methods: A total of 70 subjects were included in the study having two groups of 35 parturients in each group. Group T4 (n=35)–Hyperbaric bupivacaine (0.5%) 2.4ml cooled to the temperature of 4◦C, and Group T37 (n=35) – Hyperbaric bupivacaine (0.5%) 2.4ml warmed to the temperature of 37 ◦C. The anaesthesiologist performed the spinal block after thorough hand washing and preparing the back of the patient under all aseptic precautions as per the hospital protocol. Subarachnoid block was given with the patient in sitting position after infiltration at local area with 2% lignocaine. The patient was placed in supine position. Oxygen at a flow rate of 5L/min was given via simple face mask. Intraoperative fluid management was done with warm fluid. Heart rate, NIBP, SpO2 and temperature was monitored and noted. The core temperature was measured using a rectal thermometer with cover. All the results were analysed by SPSS software. Results: Mean time of onset of sensory block among the patients of the T4 and T37 group was 73.05 seconds and 64.88 seconds respectively. Non-significant results were obtained while comparing the onset time of sensory block among the two study groups. Non-significant results were obtained while comparing the shivering onset and core body temperature at different time intervals, non-significant result were obtained. Conclusion: Injection of cold or warm bupivacaine has no effect on the incidence of shivering.
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