Effects of intrathecal dexmedetomidine on shivering after spinal anesthesia for cesarean section: a double-blind randomized clinical trial

Abstract

BackgroundShivering is among the common troublesome complications of spinal anesthesia (SA), and causes discomfort and discontentment in parturients undergoing cesarean sections (CSs). The aim of this study was to investigate the effects of intrathecal dexmedetomidine in the prevention of shivering in those who underwent CS under SA.Subjects and methodsFifty parturients planned for elective CSs under SA were enrolled in this prospective, double-blinded, controlled study and randomly divided into two equal groups. Spinal block was achieved with 12.5 mg 0.5% heavy bupivacaine plus 5 μg dexmedetomidine (BD group) or 0.5 mL 0.9% normal saline (BN group). The incidence and intensity of shivering, peripheral and core body temperature, hemodynamic parameters, and adverse events was recorded.ResultsThe incidence of shivering was significantly higher in the BN group (52%) than the BD group (24%) (P=0.04). Likewise, the intensity of shivering was significantly higher in the BN group than the BD group (P=0.04). The incidence of adverse events, such as hypotension, nausea/vomiting, and bradycardia, was not significantly different between the two groups, although the grade of sedation was higher in the BD group than the BN group (P=0.004).ConclusionWe conclude that intrathecal dexmedetomidine is effective in lowering the incidence and intensity of shivering in parturients undergoing CSs under SA without major adverse effects.

Intravenous dexmedetomidine for the treatment of shivering during Cesarean delivery under neuraxial anesthesia: a randomized-controlled trial

“…There exists, however, scant research concerning the use of dexmedetomidine in obstetric applications. Recently, dexmedetomidine has been shown to reduce shivering during Cesarean delivery when administered intrathecally, 26,27 yet no study has considered its use intravenously. The present study evaluates the intravenous administration of dexmedetomidine to treat shivering for the first time in the obstetrical context; therefore there is no data to compare our results with.…”

Low Dose Hyperbaric Bupivacaine and Dexmedetomidine as an Adjuvant in Spinal Anaesthesia, Caesarean Section: A Randomized Controlled Trial

“…As well, shivering in LD-DEX group showed a good pro le with incidence of 5% which is much lower (P < 0.05) and came parallel to reports by Abdelhamid and El-lakany [22], Y. Sun et.al., [31] and K. Nasseri et.al., [32] Regarding nausea with or without vomiting there is no difference in incidence and is well corelated to episodes of hypotension and peritoneal traction parallel to outlined by Kang et.al. [33] We encountered several limitations in this study.…”

The efficacy and safety of intrathecal dexmedetomidine for parturients undergoing cesarean section: a double-blind randomized controlled trial

“…Consistent with the ndings of meta-analysis conducted by Miao [12] , intrathecal DEX can signi cantly reduce the incidence of shivering in parturients undergoing spinal anesthesia. The mechanism of antishivering effect can be inferred that DEX could reduce central thermos-sensitivity by weakening the electrical conductivity of neurons through mediating the α-2 adrenergic receptors in the brain and spinal cord [29,30] . Moreover, intrathecal DEX showed added advantages on block characteristics and ObsQoR-11 score compared with intrathecal fentanyl, suggesting a better clinical application prospect.…”