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Shivering is a frequently noted side effect of spinal anaesthesia. We conducted a prospective randomized study
involving 210 patients posted for elective lower limb surgery under subarachnoid block. Patients in group A received
ketamine 0.25 mg/kg with midazolam 0.02mg/kg, group B patients received ketamine 0.25 mg/kg with midazolam 0.04 mg/kg and patients in
group C received normal saline. The incidence of shivering in group C was 67% which was statistically significant while it was 2.85% in group A
and 0.7% in group B. By the end of two hours the shivering incidence was 17%, 21.4% and 11.4% in group A, group B and group C respectively.
Maximum mean sedation score was noted in group B which was statistically significant. Ketamine-midazolam combination administered
prophylactically results in significant reduction of shivering but the effect is short lived. Higher dose of midazolam offers no advantage and
results in excessive sedation.