Brazilian Journal of Anesthesiology最新文献

{"title":"Quality of recovery after laparoscopic cholecystectomy: a randomized trial of pneumoperitoneum pressure and neuromuscular blockade depth","authors":"José Fernando Amaral Meletti ,&nbsp;Marina Gasparotto Fernandes ,&nbsp;Eduardo Toshiyuki Moro ,&nbsp;Evaldo Marchi","doi":"10.1016/j.bjane.2025.844667","DOIUrl":"10.1016/j.bjane.2025.844667","url":null,"abstract":"<div><h3>Introduction</h3><div>Laparoscopic Cholecystectomy (LC) is a commonly performed surgical procedure. The pneumoperitoneum and the depth of Neuromuscular Blockade (NMB) may impact the occurrence of postoperative pain and the quality of recovery.</div></div><div><h3>Methods</h3><div>A randomized, double-blind, and prospective clinical trial with 124 patients undergoing LC, divided into 4 groups: SP/MB (Standard Pneumoperitoneum pressure and Moderate NMB); LP/MB (Low Pneumoperitoneum pressure and Moderate NMB); SP/DB (Standard Pneumoperitoneum pressure and Deep NMB); and LP/DB (Low Pneumoperitoneum pressure and Deep NMB). Recovery quality was assessed using the Quality of Recovery Questionnaire (QoR-40), and postoperative pain was evaluated using a Verbal Numerical Rating Scale (VNRS).</div></div><div><h3>Results</h3><div>No difference was observed between groups regarding the total QoR-40 score 24 hours after surgery (p = 0.903). Despite better surgical conditions (scored from 0 to 5) in the LP/DB group (4.7 ± 0.52) and lower in the LP/MB group (4.1 ± 0.95), the LP/DB group showed a longer stay in the Post-Anesthesia Care Unit (PACU), a higher need for rescue treatment for nausea and vomiting in the ward (p = 0.044), and greater resting pain at 24 hours (p = 0.027).</div></div><div><h3>Conclusion</h3><div>The use of different pneumoperitoneum pressures under moderate or deep neuromuscular blockade in patients undergoing Laparoscopic Cholecystectomy (LC) did not alter patients’ perception of postoperative recovery quality. The combination of standard pneumoperitoneum pressure with deep neuromuscular blockade was associated with a better perception of surgical field quality as evaluated by the surgeon.</div></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"75 6","pages":"Article 844667"},"PeriodicalIF":1.9,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain thresholds in elderly individuals: a cross-sectional observational study of the influence of gender and chronic non-cancer pain","authors":"Áquila Lopes Gouvêa ,&nbsp;Pedro Adde Anuardo ,&nbsp;João Paulo Consentino Solano ,&nbsp;Ângela Maria Sousa ,&nbsp;Hazem Adel Ashmawi","doi":"10.1016/j.bjane.2025.844665","DOIUrl":"10.1016/j.bjane.2025.844665","url":null,"abstract":"<div><h3>Background</h3><div>The older population is growing, and it is estimated that, by 2050, people aged 60-years or more will have reached two billion. The increased life expectancy has led to a higher incidence of chronic degenerative diseases, contributing to increased pain complaints. This study aims to compare the pain threshold after mechanical stimulation in older adults according to gender and presence or absence of chronic pain and find the prevalence and intensity of chronic pain in this population.</div></div><div><h3>Methods</h3><div>This was a cross-sectional observational study with a convenience sample in the outpatient clinic at two research centers. All participants answered sociodemographic and clinical questionnaires, and the Pressure Pain Threshold (PPT) was assessed with an algometer. Patients reporting chronic pain answered the Geriatric Pain Measure (GPM) questionnaire.</div></div><div><h3>Results</h3><div>The sample consisted of 230 individuals, aged 60 to 96 years, 67.8% women and 32.2% men. Chronic pain prevalence was 47.8%, 29.7% in men and 56.4% in women. PPT was significantly lower in women (4.49 ± 1.78 kg) than in men (6.41 ± 1.92 kg). PPT in older individuals presenting chronic pain (4.58 ± 1.93 kg) was lower than in older individuals without chronic pain (5.58 ± 2.01 kg). There was no significant difference between genders in pain assessment by GPM.</div></div><div><h3>Conclusions</h3><div>Pressure pain threshold was lower in older women and in patients with chronic pain, the association between gender and lower pain threshold was stronger than observed with chronic pain.</div></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"75 5","pages":"Article 844665"},"PeriodicalIF":1.9,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dexmedetomidine for preventing postoperative delirium in neurosurgical patients: a meta-analysis of randomized controlled trials","authors":"Virgilio Astori ,&nbsp;Bruno Pandolfi Arruda ,&nbsp;Pedro Guimarães Marcarini ,&nbsp;Lucas Destefani Natali ,&nbsp;Marcos Sampaio Meireles ,&nbsp;Daniele Fernandes Holanda","doi":"10.1016/j.bjane.2025.844662","DOIUrl":"10.1016/j.bjane.2025.844662","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"75 5","pages":"Article 844662"},"PeriodicalIF":1.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateral versus posterior quadratus lumborum block in children undergoing open orchiopexy: a double-blind randomized clinical trial","authors":"Ozgecan P. Zanbak Mutlu,&nbsp;Pinar Kendigelen,&nbsp;Ayse C. Tutuncu","doi":"10.1016/j.bjane.2025.844661","DOIUrl":"10.1016/j.bjane.2025.844661","url":null,"abstract":"<div><h3>Background</h3><div>Quadratus Lumborum Block (QLB) has recently become an effective analgesic regional technique frequently used in abdominal surgeries. However, due to the heterogeneity in studies regarding block approaches, a direct comparison of QLB types is needed. In this double-blind prospective randomized trial, we aimed to compare the effects of lateral and posterior approaches of QLB on pain and analgesic use in children undergoing orchiopexy.</div></div><div><h3>Methods</h3><div>Patients aged 6 months – 12 years undergoing elective unilateral open orchiopexy were included in the study. Patients were randomized into two groups using the closed-envelope method. Lateral or posterior QLB was applied under ultrasonography with 0.4 mL/kg 0.25% bupivacaine for both groups before the surgery. The primary outcome was the assessment of postoperative pain for 24 hours. Analgesic usage, parental satisfaction, and complications were recorded as secondary outcomes.</div></div><div><h3>Results</h3><div>Analyses were conducted on 80 patients. Both study groups achieved clinically adequate analgesia, and no significant pain score distinctions were observed within 24 hours (Total mean scores: FLACC [lateral QLB: 2.86 ± 4.69 vs. posterior QLB: 2.87 ± 3.71, p = 0.466], Wong-Baker [lateral QLB: 0.86 ± 2.03 vs. posterior QLB: 1.24 ± 1.85, p = 0.151]). No significant interaction effect between groups and postoperative time intervals on pain scores was observed (FLACC score p-interaction: 0.425, Wong-Baker score p-interaction: 0.451). There were no statistical differences in the number of patients necessitating intraoperative and postoperative analgesics. Parental satisfaction exhibited similarity between the groups, and no perioperative complications were observed in either group.</div></div><div><h3>Conclusion</h3><div>Lateral and posterior QLB provided similar perioperative analgesia in pediatric patients undergoing orchiopexy.</div></div><div><h3>Clinical trial registration number</h3><div>NCT05056038.</div></div><div><h3>Date of registration</h3><div>02 June 2021.</div></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"75 6","pages":"Article 844661"},"PeriodicalIF":1.9,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative microcirculatory monitoring using handheld video microscopy: a proof-of-concept observation","authors":"Rafael M. Linhares ,&nbsp;Eduardo Tibiriça","doi":"10.1016/j.bjane.2025.844660","DOIUrl":"10.1016/j.bjane.2025.844660","url":null,"abstract":"","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"75 6","pages":"Article 844660"},"PeriodicalIF":1.9,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory outcomes of adrenergic beta-antagonists in patients undergoing tracheal extubation: a systematic review and meta-analysis of randomized controlled trials","authors":"Lucas Cael Azevedo Ramos Bendaham ,&nbsp;Altair Pereira de Melo Neto ,&nbsp;Hilária Saugo Faria ,&nbsp;André Richard da Silva Oliveira Filho ,&nbsp;Carlos Henrique de Oliveira Ferreira ,&nbsp;Marcela da Silva Kazitani Cunha ,&nbsp;Victor Gonçalves Soares ,&nbsp;Ocílio Ribeiro Gonçalves ,&nbsp;Milene Vitória Sampaio Sobral ,&nbsp;Mohamed Doma ,&nbsp;Denis Maltz Grutcki ,&nbsp;Fabrício Tavares Mendonça","doi":"10.1016/j.bjane.2025.844659","DOIUrl":"10.1016/j.bjane.2025.844659","url":null,"abstract":"<div><h3>Background</h3><div>Tracheal extubation after general anesthesia may cause hemodynamic and respiratory complications, with no established strategies to prevent them. We conducted a meta-analysis to evaluate the safety and efficacy of beta-blockers in patients undergoing tracheal extubation.</div></div><div><h3>Methods</h3><div>We searched the MEDLINE, EMBASE and CENTRAL databases for randomized controlled trials up to 2024 comparing beta-blockers to placebo in patients undergoing tracheal extubation. Primary outcome: cough intensity; secondary: bronchospasm, bucking, hypertension. Risk Ratios (RR) with 95% Confidence Intervals (95% CI) were computed. Leave-one-out sensitivity and meta-regression analyses were performed for outcomes with high heterogeneity.</div></div><div><h3>Results</h3><div>We included 31 randomized studies, comprising 1,803 patients, of whom 965 received beta-blockers. The risk of moderate/severe cough (RR = 0.21; 95% CI 0.13 to 0.34; p &lt; 0.001; I² = 0%) and hypertension (RR = 0.28; 95% CI 0.13 to 0.58; p &lt; 0.001; I² = 45%) was significantly lower in the beta-blockers group compared with the placebo group. There were no statistically significant differences between groups in the risk of bronchospasm (RR = 0.58; 95% CI 0.17 to 1.94; p = 0.375; I² = 0%) or bucking (RR = 0.47; 95% CI 0.20 to 1.13; p = 0.093; I² = 72%). Sensitivity analysis identified Mendonça (2023) as the main heterogeneity source in bucking.</div></div><div><h3>Conclusion</h3><div>Our study demonstrates that beta-blockers reduced moderate/severe cough and hypertension in patients undergoing tracheal extubation compared with placebo with no significant difference in the risk of bronchospasm and bucking. These findings suggest beta-blockers may be a valuable strategy for preventing peri-extubation hemodynamic instability and airway hyperresponsiveness.</div></div><div><h3>Prospero register</h3><div>CRD42024542103.</div></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"75 6","pages":"Article 844659"},"PeriodicalIF":1.9,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preemptive regional nerve blocks for sternotomy in pediatric cardiac surgery: a Bayesian network meta-analysis","authors":"Bruno F.M. Wegner ,&nbsp;Gustavo R.M. Wegner ,&nbsp;Jaime A. Arias ,&nbsp;Tatiana S. Nascimento","doi":"10.1016/j.bjane.2025.844652","DOIUrl":"10.1016/j.bjane.2025.844652","url":null,"abstract":"<div><h3>Background</h3><div>Effective pain management and expedited recovery are critical in pediatric cardiac surgery. While regional anesthesia techniques provide targeted pain control and may reduce opioid use and related complications, comparative evidence among regional nerve blocks in this population is limited. This study aimed to conduct a systematic review and network meta-analysis to support clinical decision-making for optimal analgesia.</div></div><div><h3>Methods</h3><div>We conducted a Bayesian Network Meta-Analysis (NMA) including Randomized Controlled Trials (RCTs) of pediatric patients (0–12 years) undergoing cardiac surgery by sternotomy and receiving preemptive regional nerve blocks. Primary outcomes included pain scores, opioid consumption and extubation time. Both direct and indirect evidence were synthesized to rank interventions probabilistically. This study was registered on PROSPERO (CRD42024585785) and followed PRISMA Extension Statement for Reporting of Systematic Reviews Incorporating Network Meta-analyses of Health Care Interventions.</div></div><div><h3>Results</h3><div>The NMA incorporated 12 RCTs, comprising 969 participants, and evaluated seven regional nerve blocks. Among the techniques studied, transversus Thoracis Muscle Plane Block (TTPB) consistently ranked among the most effective for pain relief and recovery. Other blocks, including thoracic retrolaminar block and thoracic paravertebral block, also demonstrated notable performances. Adverse events were infrequent but inconsistently reported, preventing an adequate analysis.</div></div><div><h3>Conclusion</h3><div>This NMA identified TTPB as a consistently top-performing technique across outcomes. These findings provide promising support for its inclusion in ERAS protocols, although further high-quality trials are needed.</div></div><div><h3>Registration</h3><div>PROSPERO ID: CRD42024585785.</div></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"75 5","pages":"Article 844652"},"PeriodicalIF":1.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VCISpain: protocol for a prospective multicenter observational study to validate a standardized classification tool for tracheal intubation using videolaryngoscopy","authors":"Miguel Ángel Fernández-Vaquero ,&nbsp;Pedro Charco-Mora ,&nbsp;Jose Alfonso Sastre-Rincon ,&nbsp;Manuel Ángel Gomez-Rios ,&nbsp;Johanes Cardenas-Gomez ,&nbsp;Eugenio Martinez-Hurtado ,&nbsp;Norma Aracil-Escoda ,&nbsp;Andrea Vallejo-Tarrat ,&nbsp;Inés Thion-Soriano ,&nbsp;David Peral-Sanchez ,&nbsp;Miguel Castañeda-Pascual ,&nbsp;Miguel Rodriguez del Rio ,&nbsp;Nekari de Luis-Cabezon ,&nbsp;Joseba Gonzalez-Garcia ,&nbsp;Jesus Acosta-Martinez ,&nbsp;Silvia Gonzalez-Santos ,&nbsp;Xavier Onrubia-Fuertes ,&nbsp;Estefania Martinez-Gonzalez ,&nbsp;Andres Roca de Togores-Lopez ,&nbsp;Iratxe Gonzalez-Mendibil ,&nbsp;Marc Vives Santacana","doi":"10.1016/j.bjane.2025.844653","DOIUrl":"10.1016/j.bjane.2025.844653","url":null,"abstract":"<div><h3>Background and objective</h3><div>Videolaryngoscopy have transformed airway management by improving intubation success rates compared to direct laryngoscopy. However, its widespread adoption has been hindered by the lack of standardized classification tools for documentation and communication. This manuscript outlines the rationale and study design of the VCISpain project, which aims to evaluate the interobserver reproducibility of the Video Classification of Intubation (VCI) scale in the context of airway management using videolaryngoscopy in Spain.</div></div><div><h3>Methods</h3><div>This manuscript presents the planned methodology of the VCISpain study, a prospective, observational, multicenter, open-label study. The study will collect data on tracheal intubations performed in operating rooms, intensive care units, and emergency departments. In each case, two anesthesiologists will independently apply the VCI scale to assess blade type, Percentage of Glottic Opening (POGO), and ease of intubation.</div></div><div><h3>Ethics and registration</h3><div>The study was approved by the University of Navarra Ethics Committee (2022.079 mod1) and registered on ClinicalTrials.gov (NCT06537531). It is endorsed by the Spanish Society of Anesthesiology, Resuscitation and Pain Therapy (SEDAR) and the European Airway Management Society (EAMS).</div></div><div><h3>Conclusions</h3><div>VCISpain seeks to establish a standardized classification tool for documenting and communicating findings related to videolaryngoscopy in airway management. By presenting the study rationale and design, this protocol aims to promote transparency, ensure methodological rigor, and encourage broader discussion to refine the study prior to implementation.</div></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"75 5","pages":"Article 844653"},"PeriodicalIF":1.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the effect of intra-cuff normal saline, dexamethasone or ketamine for prevention of postoperative sore throat: a randomized controlled trial","authors":"Arun Mukesh ,&nbsp;Ankur Sharma ,&nbsp;Priyabrat Karan ,&nbsp;Darshna Rathod ,&nbsp;Shilpa Goyal ,&nbsp;Kamlesh Kumari ,&nbsp;Manbir Kaur ,&nbsp;Tanvi Meshram ,&nbsp;Pradeep Bhatia","doi":"10.1016/j.bjane.2025.844651","DOIUrl":"10.1016/j.bjane.2025.844651","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative Sore Throat (POST) may result in patient dissatisfaction and distress, which could possibly delay discharge. Various pharmacological and non-pharmacological approaches have been explored, yet effective techniques remain elusive. This research evaluates the impact of intra-cuff Dexamethasone, Ketamine, and normal saline on alleviating POST symptoms.</div></div><div><h3>Methods</h3><div>In this randomized controlled trial, 405 adult patients aged 18‒60 years undergoing short pelvic laparoscopic surgeries under general anesthesia for 1‒3 h requiring endotracheal intubation were enrolled. Patients were randomized into Group N (intra-cuff normal saline), Group D (intra-cuff Dexamethasone), and Group K (intra-cuff Ketamine). The primary outcome of this study was the incidence and severity of POST at 2, 6, 12, and 24 hours after extubation. Secondary outcomes were the incidence and severity of postoperative hoarseness of voice and postoperative cough at various time intervals.</div></div><div><h3>Results</h3><div>There were more patients in Group D without symptoms of POST (92.59 %) than in Group K (74.07 %) and Group N (67.41 %) (<em>p</em> &lt; 0.0001) at 2 h. Similarly, more patients had no symptoms of postoperative hoarseness of voice (93.33 %) and postoperative cough (93.33 %) in Group D at 2 h. Furthermore, Group D consistently exhibited the lowest incidence of POST, postoperative hoarseness of voice, and postoperative cough at various time intervals.</div></div><div><h3>Conclusions</h3><div>Intra-cuff Dexamethasone appears to be a favourable intervention for symptom alleviation of POST, postoperative hoarseness of voice, and postoperative cough during the early postoperative period.</div></div><div><h3>Clinical Trial Registry Number</h3><div>CTRI/2022/08/044,664.</div></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"75 5","pages":"Article 844651"},"PeriodicalIF":1.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of shivering post spinal anesthesia: Ondansetron vs. Nefopam ‒ a prospective randomized controlled trial","authors":"Joanna Tohme,&nbsp;Joan Chehade,&nbsp;Hicham Abou Zeid,&nbsp;Rhea Mattar,&nbsp;Nicole Naccache,&nbsp;Khalil Jabbour,&nbsp;Mohammad Ali Ismail,&nbsp;Christine Dagher","doi":"10.1016/j.bjane.2025.844650","DOIUrl":"10.1016/j.bjane.2025.844650","url":null,"abstract":"<div><h3>Background</h3><div>Post Spinal Anesthesia Shivering (PSAS) is common and linked to increased morbidity. While various methods exist to prevent it, no study has compared Nefopam and Ondansetron. This study aims to compare Ondansetron and Nefopam in preventing PSAS.</div></div><div><h3>Methods</h3><div>A prospective, randomized, controlled, and double-blind trial was conducted in the operating room of a tertiary university hospital from April 5, 2021 to April 30, 2022. It included patients aged between 18 and 65 years scheduled for surgery under spinal anesthesia. Patients received either 8 mg of Ondansetron or 20 mg of Nefopam administered intravenously over 30 min before spinal anesthesia. Main outcome measures included the number and grades of shivering episodes post spinal anesthesia at 15-minute intervals until post-anesthesia care unit discharge. Secondary outcomes included number of episodes of hypotension, bradycardia, nausea and/or vomiting. Tympanic temperature and pain at the injection site were also recorded.</div></div><div><h3>Results</h3><div>The study included 150 patients, evenly divided between the two groups. The Ondansetron group had a higher incidence of shivering compared to the Nefopam group (23.9 % vs. 16 %; <em>p</em> = 0.038), as well as higher incidences of hypotension (16 % vs. 5.3 %; <em>p</em> = 0.035) and bradycardia (13.3 % vs. 2.7 %; <em>p</em> = 0.016). The Ondansetron group had a significantly lower incidence of nausea and vomiting (12 % vs. 1.3 %; <em>p</em> = 0.010). More patients in the Nefopam group (45.3 %) reported pain during drug infusion.</div></div><div><h3>Conclusions</h3><div>Nefopam seems to be more effective than Ondansetron in preventing PSAS with fewer cardiovascular side effects. However, Ondansetron reduces the incidence of nausea and vomiting and causes no pain during administration.</div></div>","PeriodicalId":32356,"journal":{"name":"Brazilian Journal of Anesthesiology","volume":"75 5","pages":"Article 844650"},"PeriodicalIF":1.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}