Comparative study on the impact of low-dose ketamine with midazolam and with low-dose midazolam with ketamine to prevent shivering after spinal anesthesia
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Abstract:
Introduction: Shivering is one of the complications of spinal anesthesia. There are various methods to control this shivering. In this research we opted to study the effects of two different combination doses of ketamine and midazolam on the prevention of shivering after spinal anesthesia. Material and methods: Methods:The study was a double-blind clinical trial performed on 120 patients who were candidates for surgery under spinal anesthesia at Alzahra Hospital during 2017-2018. The patients were randomly allocated into 3 groups; A, B and C. Group A received 0.02 mg/kg low dose midazolam with 0.2 mg/kg ketamine. Group B received 0.04 mg/kg (regular dose) midazolam with 0.15 mg/kg low dose ketamine and group C received the same volume of normal saline as placebo before surgery. The demographic variables, intensity of shivering and the need for analgesic medications were assessed in the patients. Results: The mean blood pressure after intervention in group A was significantly lower than groups B and C. Furthermore, the intensity of shivering in group C was significantly higher that the other two groups (p<0.05. In addition, the recovery time needed for group B was significantly longer than groups A and C (p <0.05). Conclusion: Both combinations of midazolam and ketamine are effective in preventing shivering but it appeared that using low dose midazolam with ketamine is a more suitable combination than low dose ketamine with midazolam in terms of sustaining hemodynamic stability and a shorter recovery duration.
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volume 24 issue 5
pages 0- 0
publication date 2019-11
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