Intrathecal clonidine does not reduce post‐spinal shivering

Jeon, Young Tae; Kim, Y. C.; Bahk, Jae Hyon; H., S.; Lim, Young Jin

doi:10.1111/j.1399-6576.2005.00783.x

Cited by 34 publications

(25 citation statements)

References 24 publications

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“…In our study, shivering was reported in 30% of patients in the control group C and 5% in the prophylactic groups similar to incidence reported on earlier studies. [13] The exact mechanism of shivering during regional anaesthesia has not been fully established. Post-spinal shivering is probably a combination of both thermoregulatory and non-thermoregulatory shivering.…”

Section: Discussionmentioning

confidence: 99%

Magnesium Sulphate Infusion Prevents Shivering During Spinal Anaesthesia: A Randomised Double Blinded Controlled Study

Gomathi¹,

Sudhakar²

2016

jemds

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Spinal anaesthesia is the most common form of anaesthesia in our hospital. Shivering is a very common complication in patients undergoing surgery under spinal anaesthesia. Shivering increases expenditure of cardiac and systemic energy resulting in increased oxygen consumption and carbon dioxide production, lactic acidosis and raises intraocular and intracranial pressure. It also interferes with haemodynamic monitoring intraoperatively. Regional anaesthesia produces vasodilatation, which facilitates core to peripheral distribution of heat. It also increases sweating threshold and decreases vasoconstriction and shivering threshold. Intra-and postoperative management of shivering is usually done by external heating (Forced air warming, warming blankets), warmed fluids or pharmacological intervention. Prevention and treatment of established shivering should be regarded as clinically relevant intervention in the perioperative period. Therefore, a randomized double-blind control study was done using magnesium sulphate infusion in the prevention of shivering in our hospital. The aim of our study is to assess the efficacy of magnesium sulphate when used for prevention of shivering following spinal anaesthesia. METHODSInstitutional Ethical Committee approval and informed consent were obtained from all patients.INCLUSION CRITERIA 80 patients of ASA 1 and 2 belonging to either sex, aged between 18-65 years undergoing lower abdominal and lower limb surgeries were included in the study. EXCLUSION CRITERIAPatients suffering from neuromuscular disease, hyperthyroidism, cardiopulmonary disease, psychological disease, refusal to participate or temperature more than 38*C or less than 36.5*C. The patients were randomized into 2 groups namely Group M and Group C. Group M -Each of Group M patients were designated to receive 2 gms (4 mL) of magnesium sulphate in the preloading fluid over a period of 20-30 minutes. Group C -Each of Group C patients were designated to receive 4 mL of normal saline as control in the preloading fluid over a period of 20-30 minutes. Following a detailed pre-anaesthetic checkup along with relevant investigations, patients were brought to the operation theatre and connected to monitors. Then the vital signs of the patients including heart rate, temperature, non-invasive blood pressure, respiratory rate and SpO2 were continuously monitored and recorded. Both group of patients were pre-loaded with 15 mL/kg of Ringer lactate before giving spinal anaesthesia. GROUP MThe study drug of 4 mL of Inj. Magnesium Sulphate was coded and presented to the anaesthetist not involved in the management of the patient and administered by intravenous infusion by adding it in the preloading fluid before spinal anaesthesia over a period of 20-30 minutes. GROUP CThe control drug of 4 mL of normal saline was coded and presented to the anaesthetist not involved in the management of the patient and administered by intravenous infusion by adding it in the preloading fluid before spinal anaesthesia over a period of 20-30 minut...

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Section: Discussionmentioning

confidence: 99%

Magnesium Sulphate Infusion Prevents Shivering During Spinal Anaesthesia: A Randomised Double Blinded Controlled Study

Gomathi¹,

Sudhakar²

2016

jemds

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“…3 Shivering may be normal thermoregulatory mechanism in response to core hypothermia due to redistribution of heat from core to periphery. 4 However, non-thermoregulatory shivering also occurs in normothermic patients. 5 Post-anesthetic shivering may cause major discomfort to patients and aggravate wound pain by stretching incisions and increase intracranial and intraocular pressure.…”

Section: Introductionmentioning

confidence: 99%

Prophylactic use of Midazolam, Ketamine, and Ketamine plus Midazolam for prevention of perioperative shivering during spinal anaesthesia in patients undergoing infraumbilical surgeries: a comparative study

Kumar

Singh

et al. 2017

Int J Res Med Sci

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Background: Shivering is a common problem faced by an anaesthesiologist during perioperative period. Shivering occurs during both general anaesthesia and regional anaesthesia but it is more troublesome during neuraxial anaesthesia. To evaluate the effectiveness of intravenous Midazolam, Ketamine and combination of Midazolam with Ketamine in control of shivering.Methods: The study was conducted in 90 ASA I and II patients receiving neuraxial anaesthesia with comparable dose of hyperbaric bupivacaine. The patients were allocated in three groups of 30 each to receive Midazolam 75 mcg/kg, ketamine 0.5 mg/kg and Midazolam 37.5 mcg/kg plus Ketamine 0.25 mg/kg IV after the appearance of shivering. Disappearance and recurrence of shivering as well as temperature and haemodynamics were recorded with scheduled intervals.Results: IV Midazolam plus Ketamine at the dose of 37.5 mcg/kg and 0.25 mg/kg is more effective in prophylaxis of shivering than IV Midazolam 75 mcg/kg or IV Ketamine 0.5 mg/kg. Small number of patients showed, clinically as well as statistically insignificant, incidence of hypotension, bradycardia and respiratory depression of various degrees at various time intervals.Conclusions: Thus, IV Midazolam plus Ketamine at the dose of 37.5 mcg/kg and 0.25 mg/kg IV is more effective in prophylaxis of shivering than IV Midazolam 75 mcg/kg or IV Ketamine 0.5 mg/kg following subarachnoid blockade for infra umbilical surgery. The side effects like Hypotension, nausea, vomiting and pruritus are also very less with combination and prove that it is a better agent for prophylaxis of shivering following regional anesthesia.

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“…4 Main mechanisms behind shivering in surgical patients are pain, increased sympathetic tone, production of pyrogens and temperature loss during surgery. 5,6,7 Other than of these factors direct effect of local anesthetic temperature on neurons is also a main factor shivering. 8,9,10 Body sends thermal signal to urge central nervous system for regulation of whole body temperature.…”

Section: Introductionmentioning

confidence: 99%

Warm and Cold Bupivacaine; Comparing the Effect on Shivering During Infraumblical Surgeries in Children

Ahmad¹,

Khan²,

Furqan³

et al. 2017

TPMJ

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ABSTRACT... Objectives:To compare the effect of warm and cold bupivacain on shivering during infraumblical surgeries in children under spinal anesthesia. Study Design: Randomized control trial. Setting: Department of anesthesiology, Nishtar Medical College and Hospital, Multan. Period: April 2015 to April 2016. Materials and Methods: A total of 62 patients were selected for this study. SPSS version 16 was used for data analysis. Frequency and percentages were calculated for qualitative data and mean ± standard deviation was calculated for quantitative data. Results: There was a remarkable difference shivering score in both groups. Mean shivering score for warm group was 1.1 ± 1.9 and for cold group it was 2.4 ± 1.2. Effectiveness was (74%) in warm group and (19.3%) in cold group. Conclusion: There are thermo sensory fibers in spinal cord that can induce or intensify the onset of shivering, intensity of shivering can be reduced by using warm local anesthetic solution, so anesthetic solution must be warm before using in spinal anesthesia. Key words:Warm bupivacain, Cold bupivacain, Spinal anesthesia, Shivering Article Citation: Ahmad M, Khan NA, Furqan A, Waris S. Warm and cold bupivacaine; comparing the effect on shivering during infraumblical surgeries in children.

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Intrathecal clonidine does not reduce post‐spinal shivering

Abstract: The intrathecal administration of clonidine 150 microg fails to prevent post-spinal shivering; by contrast, we have confirmed that i.v. clonidine 1 microg/kg is an effective method to prevent shivering in patients undergoing spinal anesthesia for orthopedic surgery.

Cited by 34 publications

References 24 publications

Magnesium Sulphate Infusion Prevents Shivering During Spinal Anaesthesia: A Randomised Double Blinded Controlled Study

Magnesium Sulphate Infusion Prevents Shivering During Spinal Anaesthesia: A Randomised Double Blinded Controlled Study

Prophylactic use of Midazolam, Ketamine, and Ketamine plus Midazolam for prevention of perioperative shivering during spinal anaesthesia in patients undergoing infraumbilical surgeries: a comparative study

Warm and Cold Bupivacaine; Comparing the Effect on Shivering During Infraumblical Surgeries in Children

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