Dexmedetomidine for the prevention of shivering during spinal anesthesia

Abstract

PURPOSE:The aim of this study was to evaluate the effect of dexmedetomidine on shivering during spinal anesthesia.METHODS:Sixty patients (American Society of Anesthesiologists physical status I or II, aged 18-50 years), scheduled for elective minor surgical operations under spinal anesthesia with hyperbaric bupivacaine, were enrolled. They were administered saline (group C, n = 30) or dexmedetomidine (group D, n = 30). Motor block was assessed using a Modified Bromage Scale. The presence of shivering was assessed by a blinded observer after the completion of subarachnoid drug injection.RESULTS:Hypothermia was observed in 21 patients (70%) in group D and in 20 patients (66.7%) in group C (p = 0.781). Three patients (10%) in group D and 17 patients (56.7%) in group C experienced shivering (p = 0.001). The intensity of shivering was lower in group D than in group C (p = 0.001). Time from baseline to onset of shivering was 10 (5-15) min in group D and 15 (5-45) min in group C (p = 0.207).CONCLUSION:Dexmedetomidine infusion in the perioperative period significantly reduced shivering associated with spinal anesthesia during minor surgical procedures without any major adverse effect during the perioperative period. Therefore, we conclude that dexmedetomidine infusion is an effective drug for preventing shivering and providing sedation in patients during spinal anesthesia.

Comparison of Intrathecal Dexmedetomidine with Morphine as Adjuvants in Cesarean Sections

“…Moreover, shivering, nausea and vomiting were also less in the dexmedetomidine group compared with the morphine group, consistent with other studies. [25][26][27][28] The low incidence of shivering might reflect a decreased shivering threshold and a lower core temperature.…”

Efficacy of dexmedetomidine on postoperative shivering: a meta-analysis of clinical trials

“…3,9,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] Other control agents included fentanyl, [33][34][35][36] remifentanyl, 37,38 meperidine, 15 midazolam, [39][40][41] propofol, 43,44 ketamine, 45,46 tramadol, 24,47 clonidine, 42 propacetamol, 48 and buprenorphine 49 ( 8 were reported in the 39 included trials, and all studies reported every endpoint mentioned in the Methods section (reporting bias). 8 however, some bias 8 may exist in of the two trials, 27,32 as the length of surgery was not clear.…”

Role of Intravenous Dexmedetomidine in Prolonging Postoperative Analgesia and Quality of Block Following Spinal Anaesthesia. A Systemic Review and Update

“…Intravenous Dexmedetomidine in dose range of 0.5 to 1 mcg/kg has been used successfully used either for prevention [14,[67][68][69] or treatment [70][71][72] of shivering after general or regional anaesthesia. Intravenous dexmedetomidine 0.5 mcg/kg as loading dose was found 100% effective in treatment of post anaesthesia shivering following general anaesthesia in children [72].…”

“…Apart from prolonging analgesia, it has been used for prevention and treatment of shivering [14][15][16][17][18][19][20][21][22][23].…”