Reducing the occurrence of shivering with intravenous dexmedetomidine in patients undergoing caesarean delivery under spinal anaesthesia : a double-blinded, randomised controlled trial of the efficacy and safety
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Date
2019
Authors
Adnan, Wan Ahmad Asyraf Wan Md
Journal Title
Journal ISSN
Volume Title
Publisher
Pusat Pengajian Sains Perubatan, Universiti Sains Malaysia
Abstract
Background
Shivering is a very discomforting experience following spinal anaesthesia, especially in
patients undergoing caesarean delivery. The objective of this study was to investigate the
efficacy and safety of intravenous (IV) dexmedetomidine in preventing shivering in
patients undergoing caesarean delivery under spinal anaesthesia.
Methods
This was a prospective, double-blind, randomized trial involving 62 parturients
undergoing caesarean delivery under spinal anaesthesia. They were divided into 2 groups;
patients in group D (dexmedetomidine, n = 31) received 0.5mcg/kg IV dexmedetomidine
over 10 minutes followed by infusion of 0.4mcg/kg/hr until end of surgery; whilst patients
in group C (saline, n = 31) received equivalent loading and infusion volume of 0.9%
saline. The occurrence of shivering, sedation score and haemodynamic parameters were
recorded intraoperatively.
Results
The occurrence of shivering was significantly reduced in group D as compared to group
C (3.2% vs 64.5%, p < 0.001). Patients in group D were more sedated as compared to
group C (51.6% vs 0%, p < 0.001). There were no statistically significant difference in
systolic and diastolic blood pressure between both groups. Heart rate in group D were
significantly lower than group C but still within normal physiological range.
Conclusion
IV dexmedetomidine was effective in reducing the occurrence of shivering but with
significant sedative effect and lowering of heart rate than placebo. However, the value of
heart rate was still within normal range.
Description
Keywords
Anesthesia , Spinal