In Spinal Anaesthesia for Cesarean Section the Temperature of Bupivacaine Affects the Onset of Shivering but Not the Incidence: A Randomized Control Trial

Kishore, Nand; Payal, Yashwant Singh; Kumar, Nidhi; Chauhan, Nidhi

doi:10.7860/jcdr/2016/15883.7118

Cited by 10 publications

(10 citation statements)

References 22 publications

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“…31 In 2015 the study done by Yimer et al, the overall incidence of postspinal shivering was found to be 53.8%, in the study done by Safavi et al and in the study of Onyekwulu et al, it was found to be 43.3% and 42.2% respectively, and in 2016 study designed by Kishore et al showed the incidence of shivering of 49.52%. [32][33][34][35] Thus the incidence of post spinal anaesthesia shivering in the present study was in accordance with all these studies.…”

Section: Discussionsupporting

confidence: 89%

Post spinal anaesthesia shivering- incidence and associated risk factors in patients undergoing lower limb and abdominal surgeries

Kanchan

Shah

et al. 2022

Int J Res Med Sci

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Background: This study was conducted to evaluate the incidence of shivering and likely associated risk factors following spinal anaesthesia in patients undergoing lower abdominal and lower limb surgeries.Methods: The present study was conducted in MMIMSR, Department of anaesthesia from December 2016 to September 2018. It was an observational study which was conducted over a period of 2 years. Patients who were scheduled to undergo elective lower abdominal and lower limb surgeries under spinal anaesthesia were included in study.Results: The present study depicts a high incidence of post spinal shivering, which was 42.8%. Majority of the patients belonged to the young age group between 20-30 years. The mean time of onset of shivering, was around 25 mins. Duration of shivering was observed between 15-75 minutess with a mean of 43.75 and SD±19.39.Conclusions: Shivering is one of the distressing complications of spinal block, which may be deleterious to the patients with poor cardio-respiratory reserve.

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Section: Discussionsupporting

confidence: 89%

Post spinal anaesthesia shivering- incidence and associated risk factors in patients undergoing lower limb and abdominal surgeries

Kanchan

Shah

et al. 2022

Int J Res Med Sci

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“…The exact mechanism of shivering in primiparas under CSEA has not been fully established, but shivering may be caused by loss of heat to the environment, inhibition of central thermoregulatory control, and redistribution of body heat [18,19]. In the clinical setting, shivering is most often prevented or treated using pharmacological management.…”

Section: Discussionmentioning

confidence: 99%

The effects of novel α2-adrenoreceptor agonist dexmedetomidine on shivering in patients underwent caesarean section

Jin

Chen

et al. 2019

Bioscience Reports

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Objective: Meperidine used to control shivering during perioperative period has associated side effects. The present study compared the safety of selective α2-adrenoreceptor agonist dexmedetomidine and meperidine for anti-shivering in primiparas after caesarean delivery under combined spinal-epidural anesthesia (CSEA).Methods: 100 primiparas scheduled for caesarean delivery were randomly allocated to dexmedetomidine group (Group D, n=50) and meperidine positive control group (Group M, n=50). Primiparas experienced shivering that continued to cord clamping were treated with dexmedetomidine (0.5 μg/kg) or meperidine (0.5 mg/kg) after cord clamping. The primary outcome measures were incidence of nausea, vomiting, and respiratory depression. Secondary outcome measures were shivering score, vital signs including blood pressure, heart rate and O2 saturation, tympanic temperature, and sedation score.Results: Dexmedetomidine provided similar anti-shivering effects as meperidine in patients after caesarean delivery under CSEA, evidenced as all shivering primiparas responded to either dexmedetomidine or meperidine treatment within 15 min. However, incidence of nausea and vomiting were significantly lower after dexmedetomidine treatment, accompanied with more stable blood pressure. Dexmedetomidine also provided well regulation of tympanic temperature and good sedation.Conclusion: Selective α2-adrenoreceptor agonist dexmedetomidine has a better safety profile compared with meperidine for anti-shivering in primiparas undergoing caesarean delivery. Dexmedetomidine could be a better choice for anti-shivering in patients requiring caesarean section. The mechanism of anti-shivering for dexmedetomidine may relate to well regulation of temperature and good sedation.

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“…On the other hand, the most important cause of heat redistribution from the core to the periphery due to vasodilation is the induction of general or neuraxial anesthesia [ 13 ]. According to the efficacy of local anesthetics, bupivacaine and ropivacaine are most widely used in spinal anesthesia [ 14 , 15 ]. All of these point together towards a need for a comprehensive understanding of the relationship between hypothermia, core temperature change, local anesthetics, and shivering.…”

Section: Introductionmentioning

confidence: 99%

The relationship between core temperature and perioperative shivering during caesarean section under intrathecal anesthesia with bupivacaine and ropivacaine: a randomized controlled study

et al. 2021

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Purpose To assess the incidence rate of perioperative shivering for cesarean section and explore the associations between the occurrence of shivering and hypothermia, core temperature change, local anesthetic. Methods This is a prospective, randomized, controlled, double-blinded study of 100 patients consenting for caesarean section under intrathecal anesthesia. Parturients with ASA I or II accepted elective caesarean section with combined spinal-epidural anesthesia (SA). 2–2.5 ml of 0.5% bupivacaine or 0.5% ropivacaine was intrathecally injected in group B and group R, respectively. Results The intraoperative shivering incidence in group B was significantly higher than that in group R (66.7 vs. 20.5%, Pvalue < 0.001), and shivering intensity in group B was significantly greater than group R (score: 1.4 vs. 0.3, Pvalue < 0.001). The core temperature in both groups gradually decreased with the time after SA. Hypothermia (core temperature < 36.0 ℃) 5–30 min after SA was not associated with shivering. However, changes of temperature at 25 and 30 min after SA, and bupivacaine were statistically associated with shivering, with the odds of 10.77 (95% CI: 1.36–85.21, P value = 0.02), 8.88 (95% CI: 1.29–60.97, P value = 0.03), and 7.78 (95% CI: 2.94–20.59, P value < 0.01), respectively. Conclusions In our study, for cesarean section, the occurrence of shivering was associated with the local anesthetics and the change of core temperature after SA, while not the hypothermia.

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In Spinal Anaesthesia for Cesarean Section the Temperature of Bupivacaine Affects the Onset of Shivering but Not the Incidence: A Randomized Control Trial

Cited by 10 publications

References 22 publications

Post spinal anaesthesia shivering- incidence and associated risk factors in patients undergoing lower limb and abdominal surgeries

Post spinal anaesthesia shivering- incidence and associated risk factors in patients undergoing lower limb and abdominal surgeries

The effects of novel α2-adrenoreceptor agonist dexmedetomidine on shivering in patients underwent caesarean section

The relationship between core temperature and perioperative shivering during caesarean section under intrathecal anesthesia with bupivacaine and ropivacaine: a randomized controlled study

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