Effect of Ramosetron on Peroperative Shivering and Hypotension in Patients Undergoing Transurethral Resection of Prostate Surgeries under Spinal Anaesthesia. A Prospective, Double Blind, Randomized, Comparative Study.

Abstract

Background and Aims: Elderly patients undergoing transurethral resection of prostate (TURP) surgeries are more prone to shivering induced peroperative complications which anaesthesiologists should aim to prevent rather than treat. The aim of the study is to evaluate the effect of Inj ramosetron on peroperative shivering and spinal hypotension in patients undergoing transurethral resection of prostate under subarachnoid block (SAB). Method: In this prospective doubleblind, randomized, comparative study, a total of 60 patients belonging to American Society of Anaesthesiologist (ASA) I and II physical status between the age group of 60 to 85 years, scheduled for elective TURP surgeries under spinal anaesthesia were selected. The patients were randomly allocated into one of the two groups of thirty patients each. For patients allocated in Group S, 2 ml of normal saline and in group R, 0.3 mg ramosetron (2ml) was intravenously injected 5 min before the SAB. The primary outcome was the reduction in the incidence of shivering by pretreatment with ramosetron. The maximum change in the mean arterial pressure from the base line was the secondary outcome. Using normal approximation to binominal distribution the sample size was calculated. Data collection such as sensory block level, haemodynamic parameters, rectal temperature and grades of shivering were performed at 10 minute intervals. Results: Data among the groups were compared using Analysis of Variance (ANOVA) test in Matrix Laboratory (MATLAB) environment. Incidence and intensity of shivering and hypotension were significantly less in R group than the S group (P<0.001) and (P<0.001) respectively. There was no significant difference with respect to heart rate, saturation of peripheral oxygen (SPO2), sensory block level achieved and reduction in the core temperature between the two groups. Conclusion: We conclude that pretreatment with intravenous ramosetron 0.3mg given before spinal anaesthesia in geriatric patients undergoing TURP surgeries effectively reduces the incidence and intensity of shivering and hypotension associated with spinal anaesthesia.