Effect of parecoxib sodium on postoperative shivering

BACKGROUND: Postoperative shivering is one of the most common complications in patients recovering from general anaesthesia. Although a variety of pharmacological therapies have been used to control postoperative shivering, no ideal drug has been found to date. OBJECTIVES: The aim of this study was to compare the efficacy and accompanying side-effects of prophylactic parecoxib sodium with that of tramadol or placebo for the prevention of postoperative shivering. DESIGN: A randomised, double-blind clinical study. SETTING: Mianyang Central Hospital, Sichuan, China, from December 2011 to November 2012. PATIENTS: One hundred and twenty adult patients, ASA 1 or 2, aged 20 to 60 years and scheduled for elective abdominal surgery under general anaesthesia. Reasons for noninclusion included allergy to any of the medications used; severe cardiovascular disease; kidney or liver dysfunction; peptic ulcer; muscle disease; intraoperative blood or blood products transfusion; or a history of convulsions or fever. INTERVENTIONS: The patients were allocated randomly to receive parecoxib sodium 40 mg (Group P, n = 40), tramadol 2 mg kg (Group T, n = 40) or isotonic saline (Group S, n = 40) 30 min before the end of surgery. MAIN OUTCOME MEASURES: The primary outcome measure was the incidence of postoperative shivering. Secondary outcomes were scores for postoperative pain and sedation, and the incidence of postoperative nausea and vomiting. RESULTS: The incidence and severity of postoperative shivering were significantly lower in Groups P and T than in Group S (P < 0.001). The sedation scores were higher in Group T than in Groups P and S (P < 0.05). The incidence of postoperative nausea and vomiting was also significantly higher in Group T than in Groups P and S (P = 0.016). CONCLUSION: Intravenous injection of parecoxib sodium 40 mg before the end of surgery effectively reduces the occurrence and severity of postoperative shivering after general anaesthesia without significant side effects. TRIAL REGISTRATION: ChiCTR-TRC-12002870.