CONTROL OF POST-ANESTHETIC SHIVERING WITH NEFOPAM HYDROCHLORIDE IN MILDLY HYPOTHERMIC PATIENTS AFTER NEUROSURGERY

Postoperative shivering may be prevented by maintaining normothermia i ntraoperatively or it may be treated using specific drugs. The aim of this study was to compare the efficacy of nefopam hydrochloride (nefop am) to that of clonidine and meperidine in patients undergoing electiv e neurosurgical procedures. Three groups of patients were included in the stud,. Patients in group A (60) received i.v., at random, 20 mg of nefopam. 50 mg of meperidine or 150 mu g of clonidine in the immediat e postoperative period. The incidence of shivering and the time at whi ch shivering ceased were noted, along with central temperature and mai n haemodynamic changes. Group B (20) received i.v., at random, either 10 mg of nefopam or saline before awakening from anaesthesia. The effe cts of nefopam on central temperature, oxygen consumption (Vo(2)), car bon dioxide production (VcO(2)), basal metabolic rate (BMR) and energy expenditure (EE) were investigated. Group C (10) received i.v. 20 mg of nefopam during surgery: cerebrospinal fluid pressure (CSFP), cerebr al perfusion pressure (CPP) and electroencephalogram (EEC) were monito red. In group A nefopam stopped shivering in 95% of patients when comp ared to meperidine and clonidine, which were effective in 32% and 40% of patients respectively. In group B, only 10% of patients receiving n efopam had postoperntive shivering, Vo2, VcO2 and EE were significantl y lower in patients treated with nefopam than those in the control gro up, No changes in CSFP, CPP or EEG were observed in group C. In conclu sion. nefopam seems to be more effective than clonidine or meperidine in quickly suppressing shivering, without producing significant advers e reactions.