COMPARING THE EFFICACY OF ONDANSETRON VS PALONOSETRON IN THE PREVENTION OF SHIVERING UNDER SPINAL ANESTHESIA IN PATIENTS UNDERGOING TRANSURETHRAL RESECTION OF THE PROSTATE

Authors: Renganathan Sockalingam, Pavala Kannan Velu, INDUMATHY SEERALAN, Ganesh Prabhu S C

DOI: 10.18231/j.ijca.10439.1759905202

Keywords: Postanesthetic shivering, Ondansetron, Palonosetron, Spinal anaesthesia, 5-HT3 receptor antagonist

Abstract: ABSTRACT Background: Shivering is a common postanaesthetic complication that causes metabolic stress and discomfort. Pharmacological management includes 5-HT3 receptor antagonists, such as ondansetron and palonosetron; however, their comparative efficacy is unclear. This study compared the efficacy of ondansetron and palonosetron in preventing postanaesthetic shivering (PAS) in patients undergoing transurethral resection of the prostate (TURP) under spinal anaesthesia. Methods: This prospective, double-blind, randomised study involved patients assigned to Group A (ondansetron 8 mg IV) or Group B (palonosetron 0.075 mg IV) 30 min before surgery. A standardised spinal anaesthesia protocol used 0.5% bupivacaine. Patients were monitored for temperature, haemodynamic parameters, and PAS severity at multiple time points up to 120 min postoperatively. The incidence of shivering, vomiting, and temperature variations was assessed and managed. Results: The incidence of shivering was lower with palonosetron (7.8%) than with ondansetron (21.1%) (p=0.011). Vomiting was lower in the palonosetron group (6.7%) versus ondansetron (13.3%) (p=0.136). At 120 minutes postoperatively, 91.6% had temperatures ≥36°C, 1.7% were 35.5–35.9°C, 5% were 35.0–35.4°C, and 1.7% <35.0°C. Patients with shivering had higher systolic (144.0 ± 6.1 mmHg) and diastolic (95.0 ± 4.9 mmHg) blood pressures at 120 minutes than non-shivering patients (119.0 ± 5.4 mmHg, 83.2 ± 4.2 mmHg, p<0.001). Younger patients (57.0 ± 11.3 years) were more prone to shivering than older ones (62.2 ± 11.8 years, p=0.027).Conclusion: Palonosetron is more effective than ondansetron in preventing PAS, with a lower incidence of shivering and vomiting. Further studies with larger cohorts are required to validate these findings.