The effect of prophylactic clonidine on postoperative shivering

Abstract

SummaryThe primary goal of' this study was to assess the influence of clonidine administered after induction on postoperative shivering after elective peripheral surgery. The effect of clonidine on intra-operative haemodynamics (blood pressure and heart rate) during thejirst 30min after induction and on the postoperative sedation of the patient was also investigated. Two hundred and eighty male ASA 1 and 2 patients, undergoing elective peripheral surgery were randomly administered either placebo or clonidine 2 pg.kg-' intravenously over 10 min after induction of anaesthesia. Clonidine was found to reduce the total incidence (p = 0.024, the severity (p = 0.005) and the duration (p = 0.01) of postoperative shivering. Clonidine did not increase postoperative sedation or diminish overall consciousness. We conclude that administration of clonidine 2 pg.kg-' intravenously after induction of anaesthesia is safe and reduces postoperative shivering in this group of patients. Key wordsComplications; shivering. Pharmacology; clonidineRecovery from anaesthesia and surgery is frequently accompanied by involuntary muscular activity. Besides the discomfort for the patient, shivering can exacerbate postoperative pain and induce complications in patients with coronary artery disease or heart failure by increasing oxygen consumption [I] To date, no unequivocal direct evidence has been published to show that preventive pre-or postoperative administration of clonidine reduces postanaesthetic shivering after peripheral surgery. This large, randomly administered, double-blind study was performed to evaluate the influence of clonidine administered at induction on postoperative shivering after elective peripheral surgery. The effect of clonidine on intra-operative haemodynamics (blood pressure and heart rate) during the first 30 min after

Prophylactic Effect of Oral Clonidine and Tramadol in Postoperative Shivering in Lower Abdominal Surgery

“…Dhorgiol et al [22] also found that 150 mg oral clonidine was effective in preventing shivering after a subarachnoid block. Furthermore, the results of our study corresponds to the findings by Vanderstappen et al [23], who suggested that the incidence and severity of shivering in the study group was significantly lower than that in the control group.…”

Tremores intra e pós-operatório: prevenção e tratamento farmacológico

“…Vários fármacos (meperidina, cetanserina, sufentanil, alfentanil, tramadol, fisostigmina, urapidil, nefopam, doxapram e nalbufina) já foram testados para prevenir ou tratar tremores 7-9, 28,55,56 . A meperidina mostrou ser um dos mais efetivos 56,57 , agindo provavelmente no centro de regulação térmica 55 ou via receptores opióides 15 . É provável que o receptor NMDA também module a regulação térmica em vários níveis 15 .…”

“…O tremor pode ser tratado com aquecimento, aplicação de calor radiante ou fármacos 55 . Dentre as medidas utilizadas para manutenção da temperatura corporal o uso do cobertor com ar aquecido parece ser eficiente e de custo adequado 43 .…”

“…The effects of meperidine on thermal regulation seem to involve α 2 -adrenergic receptors 41 . Several drugs (meperidine, ketanserin, sufentanil, alfentanil, tramadol, physostigmine, urapidil, nefopam, doxapram, and nalbuphine) have already been tested to prevent or treat tremors 7-9, 28,55,56 . Meperidine proved to be one of the most effective 56,57 , probably by acting on the thermal regulation center 55 or through opioid receptors 15 .…”

“…Tremors can be treated by warming up the patient, applying radiant heat, or drugs 55 . Among the measures used in the maintenance of body temperature, the warm air blanket can be beneficial and cost effective 43 .…”