Intravenous Dexmedetomidine For The Management Of Shivering Post Sub Arachnoid Blockade For Conduction Of Caesarean Delivery: A Randomised Controlled Trial

ABSTRACT

Background:About 52% of patients who undergo Cesarean delivery under spinal or epidural anesthesia will experience shivering, which may interfere with the monitoring of vital signs. Recent studies have shown that dexmedetomidine could potentially help to mitigate shivering associated with anesthesia. In accordance with them we decided to investigate the capability of dexmedetomidine, an alpha 2-adrenergic agonist, in reducing the duration of shivering associated with spinal anesthesia during Cesarean delivery. Material And Methods:Forty parturient going through Cesarean delivery under spinal anesthesia and experiencing shivering were included in this randomized, double-blind, prospective trial. After delivery, the intervention group (n = 20) was administered a single intravenous bolus of dexmedetomidine (20 microgram) while the control group (n =20) was given normal saline. Randomization and allocation were based on a computer-generated list. The primary outcome parameter was the time required for an observable reduction in shivering after the intervention. Result:Eighty patients were recruited, 40 of whom presented with shivering and underwent randomization. Our study recorded that dexmedetomidine alleviated the mean duration of shivering after a single intravenous bolus to 2.2 (2.07) min after dexmedetomidine from 18.9 (12.72) min after saline (95% confidence interval [CI],). The effect of dexmedetomidine was sustained 15 min after the bolus was administered, and shivering had completely stopped in 90% of the patients in the intervention group vs. 22.6% in the control group. No adverse effects were recorded. Conclusion:Our study found that a single intravenous bolus of dexmedetomidine reduced the duration of shivering for up to 15 min during Cesarean delivery under spinal anesthesia when compared against a placebo.