Prophylactic granisetron for post-spinal anesthesia shivering in cesarean section: A randomized controlled clinical...

Area of Science:

• Anesthesiology
• Pharmacology
• Obstetrics

Background:

• The serotonergic system plays a role in post-anesthetic shivering.
• Post-spinal anesthesia shivering is a common complication during cesarean sections.

Purpose of the Study:

• To investigate the efficacy of granisetron, a serotonin antagonist, in reducing post-spinal anesthesia shivering during cesarean delivery.
• To determine the optimal prophylactic dose of granisetron for shivering prevention.

Main Methods:

• A randomized controlled trial involving parturients undergoing elective cesarean delivery under spinal anesthesia.
• Participants received either saline placebo, 0.7 mg granisetron, or 1 mg granisetron before spinal block.
• Assessment included hemodynamics, temperature, neonatal Apgar scores, shivering incidence and severity, patient satisfaction, and adverse effects.

Main Results:

• Clinically significant shivering occurred in 77.5% of placebo recipients versus 15.9% (1 mg granisetron) and 29.2% (0.7 mg granisetron).
• The 1 mg granisetron dose showed superior reduction in shivering intensity and incidence compared to placebo and the 0.7 mg dose.
• Granisetron significantly reduced pruritus and nausea, and improved patient satisfaction scores, with the 1 mg dose yielding the highest satisfaction.

Conclusions:

• Prophylactic granisetron effectively reduces the incidence and severity of perioperative shivering in a dose-dependent manner.
• A prophylactic dose of 1 mg granisetron is recommended for preventing shivering during cesarean sections under spinal anesthesia.
• Granisetron improves patient satisfaction and reduces associated adverse effects like pruritus and nausea.