---

Background and Aim: In the patients at risk of aspiration, it is necessary to induce general anesthesia and intubate their trachea as rapid sequence. Succinylcholine is the only neuromascular blocker with short onset and ultrashort acting effect, therefore choice of drug is in rapid sequence induction of anesthesia. This drug has many advantages, including low cost, short onset, short duration of action, and profound muscle relaxation with no need to reversal of muscle relaxation. The most important side effects of this drug are fasciculation, postoperative myalgia and rise in serum potassium. We compared lidocaine with atracurium in preventing these side effects. Materials and Methods: The patients aged 20-50 years, in class I or II physical status (ASA), were randomly assigned either to group A or group B. Those in group A were given atracurium (0.05 mg/kg), 3 minutes before succinylcholine. Those in group B received lidocaine (1.5 mg/kg), 30 seconds before succinylcholine at induction of anesthesia. All patients in both groups received sodium thiopental (4 mg/kg) and succinylcholine 1.5 mg/kg at induction of anesthesia. We evaluated and recorded fasciculation and myalgia in two days after operation. We also measured serum potassium before induction and 5 minutes after succinylcholine injection. In order to control of post-operative pain, we used intravenous morphine or acetaminophen as either oral or suppository. Results: 160 patients were studied. The occurrence and severity of fasciculation were the same in two groups (p>0.05). There were less myalgia in group B in comparison with group A, one and two days after operation (p<0.05). There were no significant changes in serum potassium in two groups. Conclusion: Lidocaine is as effective as atracurium in decreasing the occurrence and severity of fasciculation, following succinylcholine injection at induction of anesthesia. Lidocaine is more effective than atracurium in decreasing the occurrence and severity of myalgia.

---

  Abstract

  Background and Aim: Postoperative shivering is one of the common problems after anesthesia and can cause many complications such as heart disease, increased intraocular pressure, increased intracranial pressure and other problems. Various methods and drugs have been used for the prevention of postoperative shivering. In this study, we have investigated the pretreatment effect of ondansetron and meperidine in reducing shivering after cesarean elective by spinal anesthesia.

  Materials and Methods: In this double-blind study, 100 volunteered patients for cesarean elective using spinal were blocked and classified randomly into two groups. After the baby was born, 8 mg/kg ondansetron for the first group (O) and 0.4 mg/kg meperidine for the second group (M) was injected slowly. MAP, Heart rate and SPO₂ were measured and recorded before the operation, during the operation and after the operation. The shivering or its absence was recorded for 20 minutes after the operation by a recovery nurse.

  Results: The incidence of postoperative shivering was 10% in ondnasetron group and 24% in meperidine group. But there was no significant difference between the two groups.

  Conclusion: There was not a significant difference between the effects of ondansetron and meperidne groups.

---

Aims: Shivering is an oscillating and involuntary activity of the muscles which increases the metabolic hyperthermia and is considered as a complication in neuraxial anesthesia. Shivering also increases the cardiopulmonary activity and oxygen consumption of the tissue. In this research project, different doses of magnesium sulfate in prevention of postoperative shivering in patients undergoing spinal anesthesia were investigated.Materials and Methods: In this double-blind randomized study, 99 patients with ASA classes 1 or 2 aged between 20 -80 years old who were under spinal anesthesia were selected. The patients were divided into 3 groups of 33 each with simple sampling method. During the operation and upon completion of surgery, the patients were controlled regarding the observable shivering for one hour by the researcher. The data were analyzed using SPSS software version 22. To ensure of the normal distribution of the data, the normality test of Kolmogorov Smirnov was used. The p-value was considered significant at < 0.05 level.
Results: The results showed that there was no significant difference between groups A and B regarding the frequency and intensity of occurrence of shivering (p = 0.374). Also, no significant difference was observed between group A and group C considering the frequency and intensity of occurrence of shivering (p = 0.631). Further, the frequency and intensity of occurrence of shivering between group B and group C was not significantly different (P=0.676).
Conclusion: The results indicated that a low dose of magnesium sulfate 20% (30mg/kg) is effective in the prevention of postoperative shivering in patients undergoing spinal anesthesia to the same degree that higher doses are.