Comparison การเปรียบเทียบอุบัติการณ์ภาวะหนาวสั่นระหว่างการให้สารน้ำอุ่นกับการใช้ยา Parecoxib ป้องกันและกลุ่มควบคุมในผู้ป่วยที่ได้รับการผ่าตัดคลอดโดยวิธีการระงับความรู้สึกแบบทั่วร่างกาย

Aekvitoon  Boonsiripiyachok

Authors

Aekvitoon Boonsiripiyachok Anaesthesiology Department, Thong Pha Phum Hospital, Kanchanaburi 71180

Keywords:

cesarean section, general anesthesia, parecoxib, postoperative shivering, warmed intravenous fluids

Abstract

Objectives: To study the effectiveness of warmed intravenous fluid administration and prophylactic parecoxib in preventing post-anaesthetic shivering among patients undergoing cesarean section under general anesthesia.

Methods: A randomized controlled trial with assessor-blinded design was conducted in patients undergoing elective cesarean section under general anesthesia at two community hospitals in Kanchanaburi Province from October to November 2025. Participants were allocated by simple random sampling into three groups: warm intravenous fluid (W, n=34), prophylactic parecoxib (P, n=33), and control (C, n=33). Shivering was assessed using the Bedside Shivering Assessment Scale (BSAS). Data were analyzed using descriptive statistics, inferential statistics, Relative Risk (RR), and the Kruskal-Wallis test.

Results: Of 101 randomized participants, 100 were included in the final analysis after one exclusion. Baseline characteristics across the three groups showed no statistically significant differences. The incidence of shivering in Group W (11.8%) and Group P (12.1%) was significantly lower than that in the control group (33.3%) (p=0.034 and 0.040). Compared to the control group, Group W reduced the risk of shivering by 64.7% (RR=0.353, 95% CI: 0.125–0.998), while Group P reduced the risk by 63.6% (RR=0.364, 95% CI: 0.129–1.026). During the first 10 minutes in the recovery room, Group P had a significantly lower median pain score than Group W and the control group (p=0.004 and 0.009). No severe complications were observed in any group, with one case of nausea and vomiting (3.03%) reported in Group P.

Conclusion: Both warmed intravenous fluids and parecoxib demonstrated a trend toward reducing the incidence of postoperative shivering in patients undergoing cesarean section under general anesthesia compared to the control group. Additionally, parecoxib provided benefits in postoperative pain management without significant adverse effects.

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