I.V. Clonidine for Post-Extradural Shivering in Parturients: A Preliminary Study (original) (raw)
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Intrathecal Clonidine Prevents Perioperative Shivering In Spinal Anaesthesia in Caesarian Section
IOSR Journals , 2019
This is a double blind randomized controlled clinical study to evaluate effects of intrathecal clonidine in prevention of perioperative shivering during spinal anesthesia in caesarian sections. In this study 80 patients of ASA-1 aged between 18 to 35 years are enrolled and divided into A and B groups. Group A received 2 ml of 0.5% bupivacaine with clonidine 30µg[1.8ml of bupivacaine and 0.2ml of clonidine]and group B received 2ml of 0.5% bupivacaine [1.8ml of bupivacaine and 0.2ml of normal saline]. We observed incidence of perioperative shivering, hemodynamic stability, additional requirement of sedation or analgesia, vasopressor requirement, IV fluid requirement and any other side effects. We observed lower incidence of (5%)perioperative shivering, increased fluid requirement, increased vasopressar requirement in study group or group A when compared to control group. In control group 40% of shivering incidence is observed. Incidence of shivering, fluid requirement and vasopressor usage is statistically significant (P value<0.001). There is significant difference in mean arterial blood pressure between groups (<0.05).
The New Indian Journal of OBGYN
Objectives: Dexmedetomidine and clonidine have been used to prevent and treat shivering after spinal anaesthesia. A double blind randomized controlled trial was conducted to compare the efficacy and safety of low dose intravenous dexmedetomidine and clonidine in controlling post-spinal anaesthesia shivering during caesarean section. Methods: 260 pregnant women of American Society of Anesthesiologists physical status I and II, aged between 18-40 years posted for caesarean section who developed grade 3 or 4 shivering after spinal anaesthesia were randomly divided into two groups, Group D (n = 130) received intravenous dexmedetomidine 0.5 μg/kg and Group C (n = 130) received clonidine 0.5 μg/kg. Time required to control shivering, response rate, recurrence rate, and adverse effects were observed. Results: The time taken to cease the shivering was short (2.20 ± 0.35 min) with no recurrence in dexmedetomidine in comparison with clonidine group (5.51 ± 0.48 min). There was 27.69% recurrence with clonidine. Response rate was 100% in dexmedetomidine against 82.3% of clonidine group. The sedation level was adequate with dexmedetomidine without respiratory depression. The haemodynamic parameters and other side effects were comparable and no adverse neonatal outcome was observed in both the groups. Conclusion: Intravenous dexmedetomidine 0.5 μg/kg has early onset of effect, higher response rate without recurrence with added advantage of good sedation and stable cardiorespiratory function and neonatal outcome than clonidine 0.5 μg/kg in controlling postspinal anaesthesia shivering during caesarean section.
2021
Objective: To determine the efficacy of granisetron versus placebo (saline) for reducing shivering in patients undergoing lower segment caeserian section under spinal anaesthesia. Study Design: Comparative cross - sectional study. Place and Duration of Study: Department of Anaesthesia, Combined Military Hospital Rawalpindi, from Apr to Sep 2019. Methodology: Total 178 patients undergoing lower segment ceaserian section under spinal anaesthesia with age ranges from 18-40 years of American Society of Anaesthesiologists status I & II with full term pregnancy scheduled for elective caesarean section under spinal anaesthesia. Group A (n=92) received an intravenous bolus of 1 mg granisetron in a 10ml syringe and Group B (n=86) received intravenous bolus of normal saline in a 10ml syringe, drugs were administered immediately before spinal anaesthesia by anaesthetist as coded syringes. Heart rate, blood pressure, core body temperature and shivering scores were measured at 0 minutes, 30 minu...
International Journal of Obstetric Anesthesia, 2021
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International Journal of Scientific and Research Publications (IJSRP), 2021
BACKGROUND: Shivering is an increased muscular activity that can caused by spinal anaesthesia. Dexamethasone is a steroid drug that can lower the incidence of post anaesthetic shivering by decreasing the dermal temperature and core temperature gradient. This study aimed to compare the effect of dexamethasone and pethidine in lowering the incidence of shivering in caesarean section patients under spinal anaesthesia. METHOD: This was a post-test control group clinical trial study conducted in Central Surgical Unit at RSUP H Adam Malik Medan and University of North Sumatera Hospital for 3 months. A total of 81 samples were divided into 3 groups (pethidine; dexamethasone; normal saline, NS). Randomized triple blind method was used. The variables were tested using chi square (p<0,05). RESULT: Shivering was found in all study groups (pethidine 25,9%; dexamethasone 37%; NS 59,3%). The percentages of grade 0 shivering were 74,1%, 63%, and 40,7% in pethidine, dexamethasone, and NS group respectively (p value 0,011). There was no incidence of grade 4 shivering in pethidine group. CONCLUSION: The effects of pethidine, dexamethasone, and NS in lowering the incidence of post anaesthesia shivering in caesarean section patients under spinal anaesthesia were statistically significant (p value 0,04). There was a significant difference in shivering incidence based on shivering assessment scale among all study groups (p value 0,011).
Background: Shivering is described as an involuntary, repetitive activity of the skeletal muscles that can have deleterious effects on anaesthetized patients. This study aimed to evaluate the effectiveness of phenylephrine infusion in preventing perioperative shivering in patients undergoing lower segment cesarean section under spinal anesthesia and to observe the change in the patient's core temperature between the study and control groups. Methods: A total of 118 patients scheduled for elective lower segment cesarean section under spinal anesthesia were recruited for this prospective, double-blind, randomized controlled study. The patients were randomized into 2 groups with 59 patients per group. The phenylephrine Group received phenylephrine infusion at a rate of 0.5 mcg/kg/minutes, while the Control Group received normal saline at an equivalent rate. Systolic and diastolic blood pressure, heart rate, core temperature, and the presence and intensity of shivering were recorded before induction and every 15 minutes intraoperatively and postoperatively. Results: The incidence of intraoperative shivering was significantly lower in the Phenylephrine Group compared to control group (29.1% vs 47.5% respectively; P = .044). Postoperatively, the Phenylephrine Group also had a lower incidence of shivering (34.5% vs 42.4%), but the difference was not statistically significant (P value = 0.391). There were no significant differences in the intensity of shivering between the 2 groups perioperatively, as well as in the systolic and diastolic blood pressure and core temperature. The phenylephrine Group showed a significantly lower heart rate at 15, 30, and 45 minutes after spinal block (P value = .005, .000, and .008, respectively), and at 0 and 30 minutes (P value = .004 and .020 respectively) in the recovery room. There were no significant differences in perioperative adverse events such as hypotension, hypertension, and bradycardia. Conclusion: Phenylephrine infusion reduces the incidence of perioperative shivering in lower segment cesarean sections under spinal anesthesia.
Clonidine at induction reduces shivering after general anaesthesia
Canadian Journal of Anaesthesia, 1997
Purpose: Postanaesthetic shivering occurs in 5-65% of patients. In addition to causing discomfort, it is associated with deleterious consequences. Our objective was to investigate the effect of 150/ag clonidine, at induction of anaesthesia, on perioperative core and peripheral temperature, incidence of postanaesthetic shivering and patients' perception of cold. Methods: Sixty ASA I or 2 patients scheduled for elective orthopaedic limb surgery were randomly allocated to group I, who received 150/Jg clonidine iv, or group 2, who received a saline bolus iv, before induction. In alI patients, anaesthesia was induced with fentanyl and propofol and maintained by spontaneous respiration (via a laryngeal mask airway) of oxygen, nitrous oxide and enflurane. Core (nasopharyngeal) and peripheral (dorsal hand) temperatures were recorded at induction and 15-rain intervals. Nurses, unaware of the treatment groups, recorded visible shivering in the recovery room, When cognitive function returned, patients were asked to grade their perception of cold on a I 0 cm linear analogue scale, higher scores indicating heat discomfort.
The effect of prophylactic clonidine on postoperative shivering
Anaesthesia, 1996
(p = 0.024, the severity (p = 0.005) and the duration (p = 0.01) of postoperative shivering. Clonidine did not increase postoperative sedation or diminish overall consciousness. We conclude that administration of clonidine 2 pg.kg-' intravenously after induction of anaesthesia is safe and reduces postoperative shivering in this group of patients.
Anesthesiology and Pain Medicine
Background: Shivering frequently occurs in cesarean section (CS) under spinal anesthesia (SA), resulting in several complications. To date, pethidine has been considered as the gold standard for post-SA shivering control, but it is contraindicated in breastfeeding women. Methods: This randomized, double-blind study was conducted at Alzahra hospital in Guilan, Iran, From January 2019 to November 2020. A total of 508 eligible term parturient women were enrolled and randomly divided into four groups of low dose ketamine (K), tramadol (T), ondansetron (O), and placebo (P). The incidence and severity of shivering and patients’ complications were recorded and compared among the groups. Results: The patients were homogenous in terms of demographic variables. Shivering was witnessed in 68 (53.5%), 26 (20.5%), 75 (59.1%), and 82 (64.6%) patients in K, T, O, and P groups, respectively (P = 0.0001). Regarding shivering severity, there was a significant difference among the four groups (P = 0.0...
Saudi Journal of Anaesthesia, 2012
Background: Shivering associated with neuraxial anesthesia is a common problem that is uncomfortable for patients; it is of unknown ethnology and has no definite treatment. Purpose: the purpose of this study was to compare the effects of warm intrathecal bupivacaine stored at 23°C and cold intrathecal bupivacaine stored at 4°C on shivering during delivery under spinal anesthesia. Methods: Seventy-eight parturient women scheduled for nonemergency cesarean delivery were enrolled in the study and separated into 2 groups. the standard group received 10 mg of heavy bupivacaine 0.5% stored at room temperature (23°C) plus 10 µg of fentanyl intrathecally (warm group), and the case group received 10 mg of heavy bupivacaine 0.5% stored at 4°C plus 10 µg of fentanyl intrathecally (cold group). data collection, including sensory block level, blood pressure, core temperature, and shivering intensity, was first performed every minute for 10 min, then every 5 min for 35 min and, finally, every 10 min until the sensory level receded to l4. Results: there were no differences between the 2 groups in the amount of bleeding, pulse rate, oxygen saturation, neonatal apgar, and incidence of vomiting. the incidence and intensity of shivering decreased in the warm group (P=0.002). Conclusion: Warming of solutions can reduce the incidence and intensity of shivering in parturient candidates for cesarean delivery under spinal anesthesia.