Study the effect of odanseteron on shivering under spinal anaesthesia for gynaecogical surgeries

  • Pallavi Waghalkar Associate Professor, Department of Anaesthesiology, Seth G. S. Medical College and K.E.M. hospital, Mumbai, Maharashtra- 400012
  • Pradnya M. Malgundkar Junior Resident, Department of Anaesthesiology, Seth G. S. Medical College and K.E.M. hospital, Mumbai, Maharashtra 400012
Keywords: Ondansetron, Gynaecological Surgeries, Bupivacaine, Shivering score, Axillary and Tympanic Temperature, Anti-shivering effect


Aims and Objective: The primary aim was to study the incidence of ondansetron on shivering in patients undergoing elective gynaecological surgeries under spinal anaesthesia and secondary to record vital parameters (HR, SBP, DBP and SpO2) and side effects, if any.

Methods: This prospective observational study was performed on 70 ASA grade I and II female patients of 18 to 60 years of age to received either normal saline (Group NS) or Ondansetron (Group ODT ) 0.15mg/kg. Spinal anaesthesia was given to all patients with Bupivacaine 15 mg. 0.5% heavy 3cc + Inj. Norphine 60 microgmat L3 L4 interspace. During surgery, a shivering score was recorded at 5, 10, 15, 20, 25, 30, 60, 120 minutes. Vital parameters in terms of HR, SBP, DBP and SpO2 and side effects, if any were measured.

Results: The incidence of shivering was 8.57% in ondansetron group compared to 40% patients in NS group. Also the incidence of maximum shivering score was high in group NS compared to group ODT. At 25 and 30 minutes, heart rate was significantly greater (82.14 13.06 and 80.6 12.55) in patients receiving normal saline after which it was constant. On the other hand, at 30 and 60 minutes the SBP, DBP and MAP was significantly greater in ondansetron group as compared to normal saline group. Hypotension was comparable in both the groups.

Conclusion: The prophylactic administration of ondansetron (0.15mg/kg) I.V. before spinal anaesthesia produces anti-shivering effect, therefore it can be considered as a safe option to prevent post spinal anaesthesia shivering and reduce the risk of hypotension.


Download data is not yet available.


. Honarmand A, Safavi MR, Comparison of prophylactic use of midazolam, ketamine and ketamine plus midazolam for prevention of shivering during regional anaesthesia, Br J Anaesth. 2008; 101(4):557-62.

. Bhattacharya P, Bhattacharya L, Jain R, Agarwal R. Post Anaesthesia Shivering. Indian J. Anaesth 2003; 47(2): 88-93.

. Chagaleti S, Athuru JB, Ondansetron versus Tramadol in Prevention of Postanaesthesia Shivering following Caesarean Section Under Spinal Anaesthesia. Global Journal for Research Analysis. 2015; 4:2.

. Kelsaka E, Sibel B, Deniz K, Binnur S. Comparison of ondansetron and meperidine for prevention of shivering in patients undergoing spinal anesthesia. Reg Anesth Pain Med 2006; 31: 40-5.

. Tie H-T, Su G-Z, He K, Liang S-R, Yuan H-W, Mou J-H. Efficacy and safety of ondansetron in preventing postanesthesia shivering: a meta-analysis of randomized controlled trials. BMC Anesthesiology. 2014; 14:12.

. Powell RM, Buggy DJ: Ondansetron given before induction of anesthesia reduces shivering after general anesthesia. Anesth Analg 2000, 90:1423-7.

. Mahoori A, Noroozinia H, Hasani E, Soltanahmadi M. Comparison of Ondansetron and Meperidine for Treatment of Postoperative Shivering: A Randomized Controlled Clinical Trial. Iranian Red Crescent Medical Journal. 2014; 16(8):e13079.

. Nallam SR, Cherukuru K, Sateesh G. Efficacy of intravenous ondansetron for prevention of postspinal shivering during lower segment cesarean section: A double-blinded randomized trial. Anesth Essays Res 2017; 11:508-13.

. Joris J, Banache M, Bonnet F et al. Clonidine and ketanserin both are effective treatment for postanesthetic shivering. Anaesthesiology 1993; 79: 532539.

. Dawson NJ, Malcolm JL. Initiation and inhibition of shivering in the rat: interaction between peripheral and central factors. Clin Exp Pharmacol Physiol 1982; 9: 8993.

. Hindle AT. Recent developments in the physiology and pharmacology of 5-hydroxytryptamine. Br J Anaesth 1994; 73: 395407.

. Hammel HT. Regulation of internal body temperature. Annu Rev Physiol 1968; 30: 641710.

. Alfonsi P. Postanaesthetic shivering: epidemiology, pathophysiology, and approaches to prevention and management. Drugs 2001; 61: 2,1932,205.

. Marashi SM, Soltani-Omid S, Soltani Mohammadi S, Aghajani Y, Movafegh A. Comparing Two Different Doses of Intravenous Ondansetron With Placebo on Attenuation of Spinal-induced Hypotension and Shivering. Anesthesiol Pain Med. 2014; 4(2): e12055.

. Shakya B, Chaturvedi A, Sah BP. Prophylactic Low Dose Ketamine and Ondansetron for Prevention of Shivering During Spinal Anaesthesia. J Anaesthesiol Clin Pharmacol. 2010; 26(4): 465-9.

Original Research Articles