DOI: 10.1097/ms9.0000000000005395 ISSN: 2049-0801

Effectiveness of prophylactic administration of intravenous paracetamol for prevention of post-spinal anesthesia shivering among parturients undergoing cesarean section at a tertiary specialized hospital: a prospective cohort study, 2025

Mussie Gezahegn Teklewold, Sulaiman Jemal Muzien, Meron Abrar Awol, Tenbite Daniel Desta

Background:

Spinal anesthesia (SA) often causes shivering, which can lead to harmful physiological effects. Recent research suggests that intravenous paracetamol may help prevent this complication, but evidence is limited in low-resource settings such as Ethiopia.

Objective:

This study aimed to evaluate the effectiveness of prophylactic intravenous (IV) paracetamol in preventing post-SA shivering in mothers undergoing cesarean section.

Methods:

A prospective cohort study was conducted at a tertiary specialized hospital from January to April 2025. One hundred ASA Physical Status II parturients scheduled for cesarean delivery under SA were enrolled. Participants were divided into paracetamol (exposed) and non-paracetamol (unexposed) groups using systematic random sampling. Shivering incidence and severity, axillary temperature, mean arterial pressure, and intraoperative adverse effects were monitored at various intervals. Data were analyzed using SPSS version 27. Chi-square and Fisher’s exact tests were used for categorical data, and the Shapiro–Wilk test assessed normality. Independent-samples t-tests and Mann–Whitney U tests were used to compare group differences.

Results:

Shivering occurred in 30% of the paracetamol group versus 54% in the control group ( P = 0.015). Shivering severity also differed significantly ( P = 0.035).

Conclusion:

Prophylactic IV paracetamol significantly reduces the incidence and severity of shivering after SA in cesarean deliveries. These findings support its use and encourage further comparative studies with other agents.

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