International Journal of Medical and All Body Health Research  |  e-ISSN: 2582-8940  |  Double-Blind Peer Review  |  Open Access  |  CC BY-NC-SA 4.0

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     2026:7/4

International Journal of Medical and All Body Health Research

e-ISSN: 2582-8940 | Open Access

Comparison of Efficacy of Ondansetron and Palanosetron for Prevention of Post Spinal Shivering During Lower Limb Surgeries: A Randomized Controlled Trial

Dr. Wamiq Javed, Dr. Sharad Goel, Dr. Shailja Sharma, Dr. Abhishek Bhardwaj, Dr. Ankur Sehgal, Dr. Sakshi

Post Graduate Resident, Department of Anaesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India; Professor, Department of Anaesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India; Professor & HOD, Department of Anaesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India; Assistant Professor, Department of Anaesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India; PG Resident, Department of Anaesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India

Article Information

Volume / Issue6 / 3 (July-September 2025)
Pages141-146
AccessOpen Access

Publication Timeline

  • Received16 June 2025
  • Accepted19 July 2025
  • Published

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Abstract

Post-spinal shivering is a common and distressing complication following spinal anesthesia, occurring in 40-70% of patients undergoing lower limb surgeries. This randomized, double-blind, placebo-controlled study aimed to compare the efficacy of ondansetron and palanosetron in preventing post-spinal shivering in patients undergoing lower limb surgeries under spinal anesthesia. A total of 180 patients aged 18-65 years, ASA physical status I-II, scheduled for elective lower limb surgeries were randomly allocated into three groups of 60 patients each: Group O received ondansetron 4 mg intravenously, Group P received palanosetron 0.075 mg/kg intravenously, and Group C received normal saline as placebo, all administered 15 minutes before spinal anesthesia. The primary outcome was the incidence of post-spinal shivering during the first 2 hours postoperatively. Secondary outcomes included severity of shivering, time to onset, hemodynamic parameters, and adverse effects. The incidence of post-spinal shivering was significantly lower in both treatment groups compared to placebo: Group O (18.3%), Group P (13.3%) versus Group C (63.3%) (p<0.001). Palanosetron demonstrated superior efficacy compared to ondansetron in preventing moderate to severe shivering (5.0% vs 11.7%, p<0.05). Both drugs effectively maintained hemodynamic stability without significant adverse effects. The mean time to onset of shivering was significantly delayed in both treatment groups. Both ondansetron and palanosetron are effective in preventing post-spinal shivering during lower limb surgeries, with palanosetron showing superior efficacy in preventing severe shivering episodes. Both drugs demonstrate excellent safety profiles and should be considered as prophylactic agents in patients at high risk for post-spinal shivering.

Keywords

Post-Spinal ShiveringOndansetronPalanosetronSpinal AnesthesiaLower Limb SurgeryPrevention5-HT3 Antagonists

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How to Cite

Javed, W., Goel, S., Sharma, S., Bhardwaj, A., Sehgal, A., & Sakshi (2025). Comparison of Efficacy of Ondansetron and Palanosetron for Prevention of Post Spinal Shivering During Lower Limb Surgeries: A Randomized Controlled Trial. International Journal of Medical and All Body Health Research, 6(3), 141-146. https://doi.org/10.54660/IJMBHR.2025.6.3.141-146

Javed, Wamiq, et al. "Comparison of Efficacy of Ondansetron and Palanosetron for Prevention of Post Spinal Shivering During Lower Limb Surgeries: A Randomized Controlled Trial." International Journal of Medical and All Body Health Research, vol. 6, no. 3, 2025, pp. 141-146. https://doi.org/10.54660/IJMBHR.2025.6.3.141-146.

Javed, W., Goel, S., Sharma, S., Bhardwaj, A., Sehgal, A. and Sakshi (2025) 'Comparison of Efficacy of Ondansetron and Palanosetron for Prevention of Post Spinal Shivering During Lower Limb Surgeries: A Randomized Controlled Trial', International Journal of Medical and All Body Health Research, 6(3), pp. 141-146. doi: 10.54660/IJMBHR.2025.6.3.141-146.

Javed W, Goel S, Sharma S, Bhardwaj A, Sehgal A, Sakshi. Comparison of Efficacy of Ondansetron and Palanosetron for Prevention of Post Spinal Shivering During Lower Limb Surgeries: A Randomized Controlled Trial. International Journal of Medical and All Body Health Research. 2025;6(3):141-146. doi:10.54660/IJMBHR.2025.6.3.141-146

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