Effect of Preoperatively Administered Cyproheptadine Hydrochloride on Postoperative Shivering in Nasal Surgery

Abstract

Objective: Postoperative shivering is a common problem observed in 5-70 % of patients and it decreases patient comfort and causes postoperative complications. This study is planned in order to investigate the effects of cyproheptadine hydrochloride in prevention of postoperative shivering. Material and Methods: The study included 44 patients undergoing nasal surgery. While 21 patients were administered 10 mg of cyproheptadine, remaining 23 patients were administered placebo 45 minutes before surgery. Neuromusculer blockade was achieved using 0.5 mg/kg of atracurium in all of the patients following an anesthesia induction with 2-3 mg/kg of propofol followed by 0.5 mu g/kg of remifentanil. Ambient temperature of 22-24 degrees C was provided in the operating room during surgery. Systolic and diastolic blood pressures, heart rates and body temperatures of the patients were measured pre, post and perioperatively Postoperative shivering in extubated patients was determined using a five-graded scale at the end of the surgery. Results: Although postanesthetic shivering was found lower in cyproheptadine group (29 %) compared to placebo group (52%), the difference was not statistically significant (p>0.05). Intensity of shivering was found similar in both groups (p>0.05). Intraoperative and postoperative mean body temperatures did not show a statistically significant difference between groups (p>0.05). Conclusion: Ten mg of cyproheptadine administered as a single dose 45 minutes before surgery did not reduce postanesthetic shivering. Further studies with different dose combinations and larger series are needed for a stronger conclusion.