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Review
. 2006 Jun;96(6):732-7.
doi: 10.1093/bja/ael101. Epub 2006 May 4.

Ondansetron does not reduce the shivering threshold in healthy volunteers

R Komatsu  1 , M Orhan-Sungur, J In, T Podranski, T Bouillon, R Lauber, S Rohrbach, D Sessler
Affiliations
Review

Ondansetron does not reduce the shivering threshold in healthy volunteers

R Komatsu et al. Br J Anaesth. 2006 Jun.

Abstract

Background: Ondansetron, a serotonin-3 receptor antagonist, reduces postoperative shivering. Drugs that reduce shivering usually impair central thermoregulatory control, and may thus be useful for preventing shivering during induction of therapeutic hypothermia. We determined, therefore, whether ondansetron reduces the major autonomic thermoregulatory response thresholds (triggering core temperatures) in humans.

Methods: Control (placebo) and ondansetron infusions at the target plasma concentration of 250 ng ml(-1) were studied in healthy volunteers on two different days. Each day, skin and core temperatures were increased to provoke sweating; then reduced to elicit peripheral vasoconstriction and shivering. We determined the core-temperature sweating, vasoconstriction and shivering thresholds after compensating for changes in mean-skin temperature. Data were analysed using t-tests and presented as means (sds); P<0.05 was taken as significant.

Results: Ondensetron plasma concentrations were 278 (57), 234 (55) and 243 (58) ng ml(-1) at the sweating, vasoconstriction and shivering thresholds, respectively; these corresponded to approximately 50 mg of ondansetron which is approximately 10 times the dose used for postoperative nausea and vomiting. Ondansetron did not change the sweating (control 37.4 (0.4) degrees C, ondansetron 37.6 (0.3) degrees C, P=0.16), vasoconstriction (37.0 (0.5) degrees C vs 37.1 (0.3) degrees C; P=0.70), or shivering threshold (36.3 (0.5) degrees C vs 36.3 (0.6) degrees C; P=0.76). No sedation was observed on either study day.

Conclusions: /b>. Ondansetron appears to have little potential for facilitating induction of therapeutic hypothermia.

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Figures

Fig. 1
Fig. 1
Shivering thresholds in 10 healthy volunteers. The open circles show the shivering threshold for each volunteer on the Control and Ondansetron study days; the filled squares are the group means (SD). The shivering threshold was similar on the Control day and Ondansetron day, P = 0.76.
See this image and copyright information in PMC

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