Canadian Journal of Anaesthesia

, Volume 35, Issue 2, pp 128–133

Intravenous meperidine for control of shivering during Caesarean section under epidural anaesthesia

  • William F. Casey
  • Charles E. Smith
  • Joel M. Katz
  • Kathleen O’Loughlin
  • Sally K. Weeks


To determine the efficacy of meperidine in controlling shivering during epidural anaesthesia for Caesarean section, forty-six parturients were studied. After delivery of the infant, shivering patients received either a single dose of intravenous meperidine 50 mg, or saline in a randomized double-blind fashion. Shivering was classified on a scale of 0 to 3 (grade 0 = none, grade 3 = severe shivering that was distressing to the patient and interfered with monitoring). Shivering and other variables were recorded at epidural placement, skin incision, delivery, and 2,5,15,30 and 60 minutes following injection. Administration of meperidine resulted in a significant decrease in both the overall incidence of shivering (87 to 35 per cent, p < 0.0 J) and severity of shivering (grade 3: 57 to 0 per cent, p < 0.01), compared with saline (incidence: 87 to 83 per cent, grade 3:57 per cent, no change). This effect was apparent within two minutes of drug injection and persisted throughout the study period. There were no differences in vital signs, oxygen saturation or temperature between groups. The incidence of nausea was similar, although patients receiving meperidine were more drowsy at two and five minutes following injection (p < 0.01) compared with patients in the saline group. There were no differences in level of consciousness at the later intervals. The mechanism of action of meperidine on shivering remains to be elucidated.

Key words

anaesthesia: obstetrics anaesthesia techniques:epidural complications: shivering analgesics narcotic: intravenous meperidine 


Afin de déterminer ľefficacité de la mépéridine dans le contrôle des frissons lors ďune anesthésia épidurale pour césarienne, 46 parturientes ont été étudiées. Après ľccouchement de ľenfant, les patientes avant frissonné ont reçu à double insu soit une dose unique intraveineuse de mépéridine 50 mg ou du salin après randomisation. Les frissons ont été classifiés selon une échelle de 0 à 3 (grade 0 = aucun, grade 3 = frisson sévère qui était inconfortable pour la patiente et interférant avec la surveillance). Les frissons ainsi que ďautres variables ont été enregistrés lors de la mise en place de ľépidurale, ľincision, ľaccouchement, età 2, 5, 15, 30 et 60 minutes après ľinjection, ľadministration de mépéridine provoqua une diminution significative de ľincidence totale des frissons (87 à 35 pour cent, p < 0.01) ainsi que de la sévérité des frissons (grade 3: 57 à Opourcent,p <0.01), comparativement au salin (incidence: 87 â 83 pour cent, grade 3:57 pour cent, aucun changement). Cet effet était apparent en dedans de deux minutes après ľinjection du médicament et persista tout le long de ľétude. II n’y avait aucune différence dans les signes vitaux, la saturation ďoxygène ou la température entre les groupes. Ľincidence des nausées était identique même si les patientes avant reçu la mépéridine étaient plus somnolentes à 2 et 5 minutes après ľinjection (p < 0.01) comparativement au groupe salin. II n’y avait aucune différence dans le niveau de conscience aux autres phases de ľétude. Le mécanisme ďaction de la mépéridine sur les frissons demeure à être élucidé.


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Copyright information

© Canadian Anesthesiologists 1988

Authors and Affiliations

  • William F. Casey
    • 1
  • Charles E. Smith
    • 1
    • 2
  • Joel M. Katz
    • 1
  • Kathleen O’Loughlin
    • 1
  • Sally K. Weeks
    • 1
  1. 1.Department of AnaesthesiaRoyal Victoria Hospital and McGill UniversityMontrcal
  2. 2.Department of Cardiothoracic AnesthesiaCleveland ClinicClevelandOhio

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