Reduction in the incidence of shivering with perioperative dexmedetomidine: A randomized prospective study

Abstract

Background and Aims:Shivering is distressing to the patient and discomforting to the attending anesthesiologist, with a varying degree of success. Various drugs and regimens have been employed to abolish the occurrence of shivering. The present study aims to explore the effectiveness of dexmedetomidine in suppressing the postanesthetic shivering in patients undergoing general anesthesia.Materials and Methods:The present study was carried out on 80 patients, in American Society of Anesthesiologists I and II, aged 22–59 years, who underwent general anesthesia for laparoscopic surgical procedures. Patients were allocated randomly into two groups: group N (n = 40) and group D (n = 40). Group D were administered 1 μg/kg of dexmedetomidine intravenously, while group N received similar volume of saline during peri-op period. Cardiorespiratory parameters were observed and recorded during the preop, intraop, and postop periods. Any incidence of postop shivering was observed and recorded as per 4 point scale. Side effects were also observed, recorded, and treated symptomatically. Statistical analysis was carried out using statistical package for social sciences (SPSS) version 15.0 for windows and employing ANOVA and chi-square test with post-hoc comparisons with Bonferroni's correction.Results:The two groups were comparable regarding demographic profile (P > 0.05). Incidence of shivering in group N was 42.5%, which was statistically highly significant (P = 0.014). Heart rate and mean arterial pressure also showed significant variation clinically and statistically in group D patients during the postop period (P = 0.008 and 0.012). A high incidence of sedation (P = 0.000) and dry mouth (P = 0.000) was observed in group D, whereas the incidence of nausea and vomiting was higher in group N (P = 0.011 and 0.034).Conclusions:Dexmedetomidine seems to possess antishivering properties and was found to reduce the occurrence of shivering in patients undergoing general anesthesia.

A comparative evaluation of dexmedetomidine and fentanyl to attenuate hemodynamic response to laryngoscopy and intubation

“…The rapid speed of infusion also determines, to a large extent, the higher incidence of side-effects such as bradycardia, apnoea and irregular ventilation. 37 The results of our study are consistent with the study of Shehabiet al 23 claimed that dexmedetomidine produced predictable falls in BP and heart rate in patients given dexmedetomidine sedation in the ICU. Their results showed 16% reduction in mean systolic blood pressure (SBP) and 21% reduction in heart rate.…”

Intrathecal Dexmedetomidine Alleviates Shivering during Cesarean Delivery under Spinal Anesthesia

“…[15][16][17] The mechanism of action by which dexmedetomidine inhibits shivering is complex. Several studies have demonstrated that dexmedetomidine alleviated shivering mainly through its central α2-adrenoreceptor agonist effect.…”

Efficacy of dexmedetomidine on postoperative shivering: a meta-analysis of clinical trials

“…3,9,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] Other control agents included fentanyl, [33][34][35][36] remifentanyl, 37,38 meperidine, 15 midazolam, [39][40][41] propofol, 43,44 ketamine, 45,46 tramadol, 24,47 clonidine, 42 propacetamol, 48 and buprenorphine 49 ( 8 were reported in the 39 included trials, and all studies reported every endpoint mentioned in the Methods section (reporting bias). 8 however, some bias 8 may exist in of the two trials, 27,32 as the length of surgery was not clear.…”