Background: Post anesthesia shivering (PAS) is a common, distressing experience. Ondansetron, the classical 5-HT3 antagonist has been in use for its prevention since long. Palonosetron, a newly introduced potent antiemetic drug with better pharmacodynamics. A study was conducted to compare the efficacy of ondansetron and palonosetron in preventing PAS in patients undergoing elective lower segment caesarean section (LSCS) under spinal anaesthesia. Different observations suggest that the serotonergic system has a role in the control of postanesthetic shivering. Therefore, the sudy compared the effect of ondansetron and palonosetron in preventing PAS in patients undergoing elective lower segment caesarean section (LSCS) under spinal anaesthesia.

Methods: A double blind randomized prospective study was conducted in the Department of Anesthesia, GMC Jammu. A total of 64 patients scheduled for elective LSCS under spinal anesthesia were randomly allocated to one of the two study groups. Accordingly, 8 mg of ondansetron or 0.075 mg palonosetron was administered in the same volume intravenously 30 min preoperatively.

Results: No statistically significant intergroup difference was observed in the duration of surgery, and nasopharyngeal temperature. However, statistically significant difference was recorded for PAS, with 28.12% patients (9/32 patients) experienced shivering in Group I at 30-Minute interval, which was significantly lower in Group II (18.75%; 6 out of 32 patients) and p-value was 0.012. The difference was significant at 60-Minutes interval (p = 0.044) also.

Conclusion: When used prophylactically, palonosetron significantly reduced incidence of PAS compared to ondansetron. However, further studies with larger sample size and more heterogeneous groups are suggested.

Keywords: Spinal anesthesia, Lower Segment Caesarean Section, Ondansetron, palonosetron, post-anesthesia shivering, Core Temperature.

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Dr Rumani Ruku

Department of Anaesthesiology and Intensive Care