Objective To compare the efficacy and adverse reactions of different doses of nalbuphine in preventing shivering after combined spinal-epidural anesthesia in patients undergoing caesarean section.
Methods A total of 150 patients, aged 20-35 years, weighing 50-80 kg, ASA physical statusⅠ or Ⅱ, were randomly and double-blindly divided into 5 groups (n = 30 in each group): control group (group C) and nalbuphine groups (groups N1, N2, N3, and N4). After delivery, the patients in groups N1, N2, N3, and N4 were received an intravenous infusion dose of 0.05, 0.1, 0.15, and 0.2 mg/kg nalbuphine immediately before clamping the umbilical cord, and the equal volume of normal saline was given instead in group C. The development of shivering was recorded from the end of nalbuphine administration to the end of surgery, and the shivering intensity was estimated using Wrench grading. Ramsay sedation score was recorded 30 minutes before giving nalbuphine and 30 minutes after giving nalbuphine.The incidences of over-sedation, nausea and vomiting, hypotension, bradycardia, xerostomia, hyperhidrosis, vertigo, and traction reaction were recorded from the end of nalbuphine administration to the end of surgery.
Results Compared with group C and group N1, the incidence of shivering and traction reaction were decreased in groups N2, N3, and N4 (P < 0.05). Compared with before giving nalbuphine, the Ramsay sedation scores were significantly increased at 30 minutes after giving nalbuphine in groups N2, N3, and N4 (P < 0.05). Compared with group N4, the incidence of vertigo, xerostomia, and hyperhidrosis was decreased than that in groups C, N1, N2, and N3 (P < 0.05).
Conclusion Nalbuphine 0.1 and 0.15 mg/kg can prevent shivering after combined spinal-epidural anesthesia in patients undergoing cesarean section safely and effectively.