Objective:
Different density and temperature of local anesthetics during induction of spinal anesthesia are shown to be in close relationship in determining its spread in the cerebrospinal fluid. Shivering accompanied to neuraxial anesthesia is a common cause of patients’ discomfort; the etiology is unknown and there is no definitive treatment forthis common problem. The aim of this study was to compare the effects of warm and cold intrathecal bupivacaine on shivering during caeserian delivery under spinal anesthesia, which were stored at 23ºC and 4ºC, respectively.
Material and Methods:
The study comprised eighty parturient women for whom elective cesarean delivery was planned and we divided these patients randomly into two groups. The Group 1 were injected 10 mg of bupivacaine 0.5% stored at room temperature 23°C intrathecally, and the Group 2 were injected 10 mg bupivacaine 0.5% stored at 4°C. The demographic data of patients, operation time, bleeding during the operation were recorded. The sensory block level, blood pressure, core temperature, and shivering intensity were recorded by evaluations at 1 minute for first 10 minute, then every 5 minute for 35 minute and, finally, every 10 minutes.
Results:
There was no significant relationship between the two groups in terms of demographic data of patients, operation time, bleeding during the operation. In addition, when we compared with two groups in the amount of sensory block characteristic and hemodynamic changes we could not find any difference. The incidence of shivering increased in the 4°C group (p=0.034).
Conclusion:
Because of increasing of shivering incidence we do not recommend 4ºC bupivacaine as a safe and beneficial alternative in clinical practice.
Keywords: cesarian-section operation, cold bupivacaine, spinal anesthesia, shivering