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      EFICACIA DE KETAMINA Y MEPERIDINA PARA PREVENCIÓN DE TEMBLORES EN PACIENTES SOMETIDAS A CESÁREA BAJO ANESTESIA REGIONAL Translated title: EFFICACY OF KETAMINE AND MEPERIDINE FOR THE PREVENTION OF SHIVERING IN PATIENTS UNDERGOING CESAREAN SECTION UNDER REGIONAL ANESTHESIA

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          Abstract

          Introducción: En el postoperatorio de anestesia obstétrica, los temblores representan el 54%. Por lo cual, se pretende evitarlo en la sala de recuperación, usando medicamentos que regulen los temblores como ketamina y meperidina. Objetivos: Determinar la eficacia de la ketamina y meperidina para prevención de temblores en pacientes sometidas a cesárea bajo anestesia regional. Métodos: Se realizó un ensayo clínico, simple ciego, aleatorizado y controlado. En el Hospital Obrero N° 2, Ingresaron en el estudio 40 pacientes cumpliendo criterios de inclusión, 20 pacientes por grupo. Las dosis usadas en el grupo Ketamina de 0.25 mg/kg y grupo meperidina de 0.1 mg/Kg. Se usó la escala de Crossley para determinar temblores, medición de temperatura periférica y efectos secundarios maternos y fetales. Para análisis estadístico se usó Chi x2 de Pearson. Resultados: La edad media del estudio es 29,77±3,35 años; Tiempo quirúrgico media de 50 ± 8,8 minutos;Temperatura en quirófano más frecuente se encontraba entre 22° a 23° C; La temperatura periférica se encontró entre 36.6°C a 37.5 °C; en el grupo de meperidina se presentó más nauseas. No existen efectos secundarios en neonatos. Conclusiones: Los temblores redujeron en los pacientes que recibieron ketamina mientras que en los que recibieron meperidina presentaron más nauseas como efecto secundario.

          Translated abstract

          Introduction: The presence of shiviring in obstetric anesthesia in the postoperative period is up to 54%. Therefore, it is intended to avoid in the recovery room, using medications that regulate shiviring such as ketamine and meperidine. Objectives: To determine the efficacy of ketamine and meperidine for the prevention of shivering in patients undergoing cesarean section under regional anesthesia. Methods: A single-blind, randomized, controlled clinical trial was conducted. In Hospital Obrero N ° 2, 40 patients enrolled in the study meeting inclusion criteria, 20 patients per group.The doses used in the Ketamine group of 0.25 mg / kg and meperidine group of 0.1 mg / Kg. The Crossley scale was used to determine shivering, peripheral temperature measurement and maternal and fetal side effects. For statistical analysis, Chi x2 from Pearson was used. Results: The average age of the study is 29.77 ± 3.35 years; Average surgical time of 50 ± 8.8 minutes;Temperature in the most frequent operating room was between 22 ° to 23 ° C;The peripheral temperature was between 36.6 ºC to 37.5 ºC; in the meperidine group there was more nausea; No neonatal side effects. Conclusions: Patients who received ketamine is better at preventing tremors while patients who received meperidine had more nausea as a side effect.

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          Intrathecal Dexmedetomidine Alleviates Shivering during Cesarean Delivery under Spinal Anesthesia

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            Intravenous ketamine during spinal and general anaesthesia for caesarean section: systematic review and meta-analysis.

            Intravenous ketamine has been used during general and regional anaesthesia for caesarean section. No systematic review and meta-analysis on the desired effects and adverse effects of ketamine administration during caesarean section have yet been performed.
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              Prophylactic ketamine to prevent shivering in parturients undergoing Cesarean delivery during spinal anesthesia.

              To compare the efficacy and safety of ketamine 0.25 mg/kg with ketamine 0.5 mg/kg to prevent shivering in patients undergoing Cesarean delivery. Prospective, randomized, double-blinded, placebo-controlled study. Operating rooms and postoperative recovery rooms. 120 ASA physical status 1 and 2 pregnant women scheduled for Cesarean delivery during spinal anesthesia. Patient characteristics, anesthetic and surgical details, Apgar scores at 1 and 5 minutes, and side effects of the study drugs were recorded. Heart rate, mean arterial pressure, oxygen saturation via pulse oximetry, tympanic temperature, severity of shivering, and degree of sedation were recorded before intrathecal injection and thereafter every 5 minutes. Patients were randomized to three groups: saline (Group C, n=30), intravenous (IV) ketamine 0.25 mg/kg (Group K-0.25, n=30), or IV ketamine 0.5 mg/kg (Group K-0.5, n=30). Grade 3 or 4 shivering was treated with IV meperidine 25 mg and the prophylaxis was regarded as ineffective. The number of shivering patients was significantly less in Group K-0.25 and in Group K-0.5 than in Group C (P = 0.001, P = 0.001, respectively). The tympanic temperature values of Group C were lower at all times of the study than in either ketamine group. Median sedation scores of Group K-0.5 were significantly higher than in Group K-0.25 or Group C at 10, 20, 30, and 40 minutes after spinal anesthesia. Prophylactic IV ketamine 0.25 mg/kg was as effective as IV ketamine 0.5 mg/kg in preventing shivering in patients undergoing Cesarean section during spinal anesthesia. Copyright © 2013 Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                rccm
                Revista Científica Ciencia Médica
                Rev Cient Cienc Méd
                Facultad de Medicina, Universidad Mayor de San Simón. (Cochabamba, Cochabamba, Bolivia )
                2077-3323
                2220-2234
                2020
                : 23
                : 1
                : 38-43
                Affiliations
                [01] orgnameCaja Nacional de Salud orgdiv1Hospital Obrero N° 2 wonderful122.paa@ 123456gmail.com
                Article
                S1817-74332020000100006 S1817-7433(20)02300100006
                994720fd-5c12-4f7b-8c01-068179583ebe

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 12 October 2018
                : 07 March 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 16, Pages: 6
                Product

                SciELO Bolivia

                Categories
                ARTÍCULOS ORIGINALES

                Ketamine,Ketamina,Anestesia Obstétrica,Meperidina,Meperidine,Anesthesia Obstetrical

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