Efficacy and safety of dexmedetomidine to prevent shivering in cesarean delivery under spinal anesthesia: a double-blind, randomized controlled trial

Abstract

Background & objective:  Postoperative shivering is a source of much discomfort to the patients following spinal anesthesia (SA), especially in patients undergoing cesarean delivery. The anesthetists have employed various medications and a variety of measures to prevent shivering in their patients. The objective of this study was to investigate the efficacy and safety of intravenous (IV) dexmedetomidine in preventing shivering in patients undergoing cesarean delivery under SA. Methodology: This prospective, double-blind, randomized trial involved 62 parturients undergoing cesarean delivery under SA. They were randomly divided into two groups; patients in dexmedetomidine group (Group D, n = 31) received dexmedetomidine 0.5 µg/kg IV over 10 min followed by infusion of 0.4 µg/kg/h until the end of surgery; whilst patients in the control group (Group C, n = 31) received equivalent loading and infusion volume of 0.9% saline. Both groups were operated upon by a standardized spinal anesthesia technique. The occurrence of shivering, sedation score and hemodynamic parameters were recorded intraoperatively. The recording anesthetist was blinded regarding the study or the control groups. 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 was no statistically significant difference in systolic and diastolic blood pressure readings between both of the groups. Heart rates in Group D were significantly lower than the Group C but still were 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 the placebo. Although the heart rates remained within normal range in both groups. Key words: Anesthesia, Spinal; Cesarean; Dexmedetomidine; Shivering Citation: Wan Md Adnan WAA, Wan Hassan WMN, Seevaunnamtum P, Omar SC, Nik Mohamad NA. Efficacy and safety of dexmedetomidine to prevent shivering in cesarean delivery under spinal anesthesia: a double-blind, randomized controlled trial. Anaesth. pain intensive care 2023;27(6):632−638; DOI: 10.35975/apic.v27i6.2346 Received: January 09, 2023; Reviewed: January 29, 2023; Accepted: February 08, 2023