Prevention of postspinal shivering by using ketamine plus midazolam in comparison with nefopam

ObjectivesPostspinal shivering is a frequent complication following spinal anesthesia. The aim of this study was to compare the effectiveness of nefopam with that of ketamine plus midazolam and placebo in the prevention of postspinal shivering.MethodsWe studied 226 patients undergoing elective orthopedic surgery. Patients were located to one of three groups, group N (n = 76) received 0.2 mg kg−1 nefopam, group K (n = 75) received ketamine 0.25 mg plus midazolam 40 μg kg−1 and group S (n = 75) received saline 0.9% as placebo.ResultsWe found a significant reduction in the incidence of shivering in group N and group K in comparison to group S. There were no significant differences in hypotenion and bradycardia in all groups. Sedation was significant in group K in comparison with group N and S.ConclusionThe results of our study showed that nefopam (0.2 mg kg−1) is as effective as ketamine 0.25 mg plus midazolam 40 μg kg−1 in the prophylaxis of postspinal shivering and not accompanied by sedation or hemodynamic side effects.