The effects of parecoxib sodium and flurbiprofen axetil injection on postoperative shivering: a randomized, double-blinded clinical trial

Objective: Postoperative shivering can cause patients serious adverse events and influence their outcomes after general anesthesia. To date there is no ideal drug which can be used to prevent post operative shivering. The aim of this randomized controlled trial was to examine the efficacy and accompanying side effects of prophylactic flurbiprofen along with parecoxib or placebo for reducing postoperative shivering. Methods: 145 patients with American Society of Anesthesiologists physical status I-II, who were scheduled for colorectal surgery under general anesthesia were selected. Subjects were randomly assigned to receive flurbiprofen 50 mg (Group F), parecoxib sodium 40 mg (Group P) or normal saline (Group S) 40 minutes before the end of surgery. Heart rate and mean blood pressure were recorded. The occurrence of shivering, visual analogue score (VAS), ramsy sedation scale (RSS), postoperative nausea and vomiting were recorded an hour after extubation. Results: The incidence and severity of postoperative shivering were significantly lower in Groups P (18.75%) and F (20.41%) than in Group S (50%, P<0.01). The visual analogue score was significantly lower in Groups P and F than in Group S at the time of extubation, 30 minutes after extubation and 60 minutes after extubation (P<0.01). There was no significant difference between Groups P and F. Compared to Group S, there were no significant difference in the sedation scores and the incidence of postoperative nausea and vomiting in Groups P and F. Conclusions: Intraoperative intravenous administration of flurbiprofen (50 mg) or parecoxib sodium (40 mg) is effective in decreasing the incidence and severity of postoperative shivering in patients undergoing colorectal surgery under general anesthesia, and does not pose significant risk of side effects.