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Effect of palonosetron on postanesthetic shivering after propofol–remifentanil total intravenous anesthesia

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Abstract

Purpose

The authors conducted a prospective, randomized, double-blind study to evaluate the anti-shivering efficacy of palonosetron for patients after gynecological laparoscopy under total intravenous propofol–remifentanil anesthesia.

Methods

Sixty female patients were randomly assigned to one of two groups and administered palonosetron 0.075 mg (palonosetron group, n = 30) or the same volume of normal saline (control group, n = 30) immediately after anesthesia induction. Anesthesia was induced and maintained with propofol and remifentanil, using a target-controlled infusion device. Esophageal and index finger temperatures were measured immediately after anesthesia induction (baseline) and at 15-min intervals until the end of the surgery. Postanesthetic shivering and side effects were assessed in a postanesthetic care unit.

Results

Incidence of shivering was comparable in the control and palonosetron groups (10/30 vs. 8/30, respectively, P = 0.779). No significant intergroup differences were observed between esophageal and index finger temperatures. Compared with baseline values, esophageal temperatures decreased immediately after pneumoperitoneum in the control group and from 30 min after pneumoperitoneum in the palonosetron group.

Conclusion

Use of palonosetron (0.075 mg) did not reduce the incidence of postanesthetic shivering after gynecological laparoscopy under propofol–remifentanil anesthesia. Further study including other 5-HT3 antagonists or male patients would elucidate the effect of palonosetron on shivering after propofol–remifentanil anesthesia.

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References

  1. Crossley AWA. Perioperative shivering. Anaesthesia. 1992;47:193–5.

    Article  PubMed  CAS  Google Scholar 

  2. Bay J, Nunn JF, Prys-Roberts C. Factors influencing arterial PO2 during recovery from anaesthesia. Br J Anaesth. 1968;40:398–407.

    Article  PubMed  CAS  Google Scholar 

  3. Alfonsi P. Postanaesthetic shivering. Epidemiology, pathophysiology and approaches to prevention and management. Minerva Anestesiol. 2003;69:438–42.

    PubMed  CAS  Google Scholar 

  4. Larsen B, Seitz A, Larsen R. Recovery of cognitive function after remifentanil–propofol anesthesia: a comparison with desflurane and sevoflurane anesthesia. Anesth Analg. 2000;90:168–74.

    Article  PubMed  CAS  Google Scholar 

  5. Juckenhöfel S, Feisel C, Schmitt HJ, Biedler A. TIVA with propofol–remifentanil or balanced anesthesia with sevoflurane-fentanyl in laparoscopic operations. Hemodynamics, awakening and adverse effects. Anaesthesist. 1999;48:807–12.

    Article  PubMed  Google Scholar 

  6. Röhm KD, Riechmann J, Boldt J, Suttner SW, Piper SN. Total intravenous anesthesia with propofol and remifentanil is associated with a nearly twofold higher incidence in postanesthetic shivering than desflurane-fentanyl anesthesia. Med Sci Monit. 2006;12:CR452–6.

    Google Scholar 

  7. Nakasuji M, Nakamura M, Imanaka N, Tanaka M, Nomura M, Suh SH. Intraoperative high-dose remifentanil increases post-anaesthetic shivering. Br J Anaesth. 2010;105:162–7.

    Article  PubMed  CAS  Google Scholar 

  8. Mazzola-Pomietto P, Aulakh CS, Murphy DL. Temperature, food intake, and locomotor activity effects of a 5-HT3 receptor agonist and two 5-HT3 receptor antagonists in rats. Psychopharmacology. 1995;121:488–93.

    Article  PubMed  CAS  Google Scholar 

  9. Komatsu R, Orhan-Sungur M, In J, Podranski T, Bouillon T, Lauber R, Rohrbach S, Sessler DI. Ondansetron does not reduce the shivering threshold in healthy volunteers. Br J Anaesth. 2006;96:732–7.

    Article  PubMed  CAS  Google Scholar 

  10. Powel RM, Buggy DJ. Ondansetron given before induction of anesthesia reduces shivering after general anesthesia. Anesth Analg. 2000;90:423–7.

    Google Scholar 

  11. Sagir O, Gulhas N, Toprak H, Yucel A, Begec Z, Ersoy O. Control of shivering during regional anaesthesia: prophylactic ketamine and granisetron. Acta Anaesthesiol Scand. 2007;51:44–9.

    Article  PubMed  CAS  Google Scholar 

  12. Sajedi P, Yaraghi A, Ali Moseli HA. Efficacy of granisetron in preventing postanesthetic shivering. Acta Anaesthesiol Taiwan. 2008;46:166–70.

    Article  PubMed  Google Scholar 

  13. Dhimar AA, Patel MG, Swadia NV. Tramadol for control of shivering (comparison with pethidine). Indian J Anaesth. 2007;51:28–31.

    Google Scholar 

  14. Bessell JR, Karatassas A, Petterson JR, Jamieson GG, Maddern GJ. Hypothermia induced by laparoscopic insufflations: a randomized study in a pig model. Surg Endosc. 1995;9:791–6.

    PubMed  CAS  Google Scholar 

  15. Moore SS, Green CR, Wang FL, Pandit SK, Hurd WW. The role of irrigation in the development of hypothermia during laparoscopy surgery. Am J Obstet Gynecol. 1997;176:598–602.

    Article  PubMed  CAS  Google Scholar 

  16. Ikeda T, Sessler DI, Kikura M, Kazama T, Ikeda K, Sato S. Less core hypothermia when anesthesia is induced with inhaled sevoflurane than with intravenous propofol. Anesth Analg. 1999;88:921–4.

    PubMed  CAS  Google Scholar 

  17. Matsukawa T, Sessler DI, Sessler AM, Schroeder M, Ozaki M, Kurz A, Cheng C. Heat flow and distribution during induction of general anesthesia. Anesthesiology. 1995;82:662–73.

    Article  PubMed  CAS  Google Scholar 

  18. Sessler DI. Temperature monitoring. In: Miller RD, editor. Anesthesia. New York: Churchill Livingstone Inc; 1994. p. 1363–82.

    Google Scholar 

  19. Guyton AC. Body temperature, temperature regulation and fever. In: Guyton AC, editor. Textbook of medical physiology. 6th ed. Philadelphia: WB Saunders Inc; 1991. p. 886–98.

    Google Scholar 

  20. Browning RM, Fellingham WH, O’Loughlin EJ, Brown NA, Paech MJ. Prophylactic ondansetron does not prevent shivering or decrease shivering severity during cesarean delivery under combined spinal epidural anesthesia: a randomized trial. Reg Anesth Pain Med. 2012. doi:10.1097/AAP.0b013e31827049c6 (in press).

  21. Rojas C, Stathis M, Thomas AG, Massuda EB, Alt J, Zhang J, Rubenstein E, Sebastiani S, Cantoreggi S, Snyder SH, Slusher B. Palonosetron exhibits unique molecular interactions with the 5-HT3 receptor. Anesth Analg. 2008;107:469–78.

    Article  PubMed  CAS  Google Scholar 

  22. Nakasuji M, Nakamura M, Imanaka N, Tanaka M, Nomura M, Suh SH. An intraoperative small dose of ketamine prevents remifentanil-induced postanesthetic shivering. Anesth Analg. 2011;113:484–7.

    PubMed  CAS  Google Scholar 

  23. Ryu JH, Kang MH, Park KS, Do SH. Effects of magnesium sulphate on intraoperative anaesthetic requirements and postoperative analgesia in gynaecology patients receiving total intravenous anaesthesia. Br J Anaesth. 2008;100:397–403.

    Article  PubMed  CAS  Google Scholar 

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Conflict of interest

No external funding was provided for this study, and the authors have no competing interests to declare.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, Gachon University, Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, Republic of Korea

    Youn Yi Jo, Hyun Jeong Kwak & Mi Geum Lee

  2. Department of Rehabilitation Medicine, Gachon University, Gil Medical Center, Incheon, Republic of Korea

    Oh Kyung Lim

Authors
  1. Youn Yi Jo
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  2. Hyun Jeong Kwak
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  3. Mi Geum Lee
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  4. Oh Kyung Lim
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Correspondence to Hyun Jeong Kwak.

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Jo, Y.Y., Kwak, H.J., Lee, M.G. et al. Effect of palonosetron on postanesthetic shivering after propofol–remifentanil total intravenous anesthesia. J Anesth 27, 535–540 (2013). https://doi.org/10.1007/s00540-013-1556-1

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  • DOI: https://doi.org/10.1007/s00540-013-1556-1

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