Most Read Articles
Saras Ramiya, 15 Apr 2017
After being introduced to Malaysia 10 years ago, Bio-Oil has established itself as a staple skincare brand.
Jenny Ng, 05 Aug 2015
Concerns emerge over combining antidepressants with non-steroidal anti-inflammatory drugs (NSAIDs) as a study shows an increased risk of intracranial haemorrhage (ICH) in these patients. 
Debra Kennedy, 01 Jun 2014

Pregnant women do not need to suffer unnecessary pain or potentially dangerous fever for fear of their taking medications that may be harmful to their unborn baby. Healthcare providers should be confident when prescribing appropriate treatment to such women during pregnancy.

Harriet Pugsley, MB ChB, MRCOG; Judith Moore, MRCOG, 01 Aug 2013

Most women presenting with complications in early pregnancy are assessed, diagnosed and managed at early pregnancy assessment units (EPAUs). These units aim to provide thorough assessments, access to specialist investigations (scan, human chorionic gonadotrophin [hCG]), a rapid turnaround of results, and co-ordination of further management.

Adjuvant low-dose intrathecal meperidine cuts incidence of spinal shivering

17 Nov 2017
The opioid epidemic in the US has presented a complicated moral dilemma to doctors when treating potential drug abusers.

Adjuvant intrathecal meperidine in low doses is effective for preventing anaesthesia-associated spinal shivering and reduces the need for rescue analgesics, according to a new meta-analysis.

Pooled data from 21 randomized controlled trials (RCTs), corresponding to 1,535 subjects, showed that adjuvant low-dose meperidine significantly reduced the incidence of shivering compared with controls (risk ratio [RR], 0.31; 95 percent CI, 0.24 to 0.40; p<0.00001). Moreover, relative risk reduction (RRR) was calculated to be 66.1 percent while the absolute RR (ARR) was 29.2 percent.

The effect of adjuvant low-dose intrathecal meperidine on shivering incidence, based on the four-level intensity scale, was examined in 15 RCTs corresponding to 1,198 patients. A meta-analysis of these trials found a preventive effect for grade I (RR, 0.62; 0.41 to 0.94; p=0.02) and II (RR, 0.35; 0.23 to 0.53; p<0.00001) shivering.

The risks for grade III (RR, 0.26; 0.16 to 0.41; p<0.00001) and IV (RR, 0.15; 0.08 to 0.28; p<0.00001) shivering were likewise reduced by the meperidine intervention.

Compared with controls, those who received the meperidine intervention also had a significantly reduced need for intraoperative rescue analgesics (RR, 0.27; 0.12 to 0.64; p=0.003), with RRR and ARR of 73.3 and 10.6 percent, respectively.

In contrast, adjuvant low-dose intrathecal meperidine significantly increased the risk of nausea (RR, 1.84; 1.29 to 2.64; p=0.0009) and vomiting (RR, 2.23; 1.23 to 4.02; p=0.008), but only moderately statistically increased the incidence of pruritus (RR, 2.31; 0.94 to 5.70; p=0.07).

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Pharmacy - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
Saras Ramiya, 15 Apr 2017
After being introduced to Malaysia 10 years ago, Bio-Oil has established itself as a staple skincare brand.
Jenny Ng, 05 Aug 2015
Concerns emerge over combining antidepressants with non-steroidal anti-inflammatory drugs (NSAIDs) as a study shows an increased risk of intracranial haemorrhage (ICH) in these patients. 
Debra Kennedy, 01 Jun 2014

Pregnant women do not need to suffer unnecessary pain or potentially dangerous fever for fear of their taking medications that may be harmful to their unborn baby. Healthcare providers should be confident when prescribing appropriate treatment to such women during pregnancy.

Harriet Pugsley, MB ChB, MRCOG; Judith Moore, MRCOG, 01 Aug 2013

Most women presenting with complications in early pregnancy are assessed, diagnosed and managed at early pregnancy assessment units (EPAUs). These units aim to provide thorough assessments, access to specialist investigations (scan, human chorionic gonadotrophin [hCG]), a rapid turnaround of results, and co-ordination of further management.