Comparison of granisetron 10 µg/kg vs 40 µg/kg intravenous for prophylaxis of shivering after spinal anesthesia for lower abdominal surgery

Abstract

Background & Objective: Postanesthetic shivering is one of the many complications during recovery that is marked by vasoconstriction and involuntary movements in several muscle groups and psychologically is an incredibly uncomfortable experience for the patient. The 5-HT3 receptor antagonist granisetron can potentially be used to manage postanesthetic shivering through the thermoregulation neurotransmission system. This study aims to compare the effects of administering 10 µg/kg or 40 µg/kg of granisetron intravenously on the grade of shivering post spinal anesthesia in lower abdominal surgeries. Methodology: This study was a single-blind experimental study conducted on 30 patients who underwent spinal anesthesia for lower abdominal surgeries in Dr. Hasan Sadikin Hospital Bandung. There were no statistical differences of age, weight, height, BMI, core temperature before anesthesia, block height, room temperature, total bleeding, input volume, duration of surgery, and use of ephedrine between the two intervention groups. Results: Administration of 40 µg/kg intravenous granisetron could maintain the body temperature above 36.56 °C , better than the 10 µg/kg intravenous granisetron with the lowest temperature at 35.31 °C. Regarding the grade of shivering, administration of 40 µg/kg granisetron IV was able to improve postanesthetic shivering up to grade 2 in 3 (20%) patients, while 10 µg/kg intravenous granisetron improved grade of shivering to grade 3 in 5 (33%) patients, these results were statistically significant (P < 0.05). Conclusion: In conclusion, administration of granisetron 40 µg/kg IV reduces the incidence and severity of shivering post spinal anesthesia, and maintains a better core temperature compared to granisetron 10 µg/kg IV.Keywords: 5-Ht3 Receptor Antagonist; Granisetron; Postanesthetic Shivering; Prophylaxis Citation: Wahid WR, Pradian E, Prihartono MA. Comparison of granisetron 10 µg/kg vs 40 µg/kg intravenous for prophylaxis of shivering after spinal anesthesia for lower abdominal surgery. Anaesth. pain intensive care 2023;27(4):553−557; DOI: 10.35975/apic.v27i4.2265 Received: October 20, 2021; Reviewed: March 19, 2023; Accepted: June 22, 2023