MedPath

Dexmedetomidine in Post Spinal Anesthesia Shivering

Phase 2
Completed
Conditions
Shivering Caused by Spinal Anesthesia
Interventions
Registration Number
NCT02382432
Lead Sponsor
Assiut University
Brief Summary

This study evaluated the effect of dexmedetomidine iv in three different doses in the treatment of shivering in patients undergoing minor elective abdominal surgery under spinal anesthesia, in comparison with intravenous pethidine.

Detailed Description

Among the pharmacological agents used in treatment of shivering, pethidine (meperidine) has been shown to be one of the most effective treatments.The α-2 receptor agonists are another important class of anti-shivering drugs that, unlike meperidine, produce little respiratory depression.

Dexmedetomidine is a highly selective α-2 adrenoceptor agonist with potent effects on the central nervous system . Intravenous dexmedetomidine reduces both the vasoconstriction and shivering thresholds . Clinical studies had demonstrated the efficacy of dexmedetomidine in prevention of shivering . Few clinical trials investigated its efficacy in treatment of established shivering. The optimum dose for shivering control with the least hemodynamic derangements is still under research.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
120
Inclusion Criteria
  • American Society of Anesthesiologist class I or II scheduled for elective minor lower abdominal operations under spinal anesthesia for an anticipated duration of >60 and <180 min. (e.g. inguinal herniorRaphy, umbilical hernia repair) who developed shivering during the intra or postoperative period
Exclusion Criteria
  • Patients with BMI>30 kg /m2
  • Initial body temperature >38 C or <36 C and those with a history of convulsions
  • Multiple allergies
  • Thyroid disease
  • Parkinson's disease
  • Dysautonomia
  • Raynaud's syndrome
  • Hypertension
  • Coronary artery disease or other cardio-respiratory or neuromuscular pathology
  • Middle ear pathology
  • A known history of alcohol use
  • Treatment with sedative hypnotic agents or vasodilators
  • Having contraindications to spinal anesthesia

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Pethidine 0.4mg/kg ivPethidine 0.4mg/kginterventional: Pethidine 0.4mg/kg intravenous bolus once to be repeated if shivering incompletely abolished.
DEX. IDexmedetomidineInterventional:Dexmedetomidine (Precedex) 0.5µg/kg intravenous bolus once to be repeated if shivering incompletely abolished.
DEX. IIDexmedetomidineInterventional: Dexmedetomidine (PRECEDEX) 0.3µg/kg intravenous bolus given once to be repeated if shivering incompletely abolished.
DEX IIIDexmedetomidineInterventional: Dexmedetomidine (PRECEDEX) 0.2µg/kg intravenous bolus given once to be repeated if shivering incompletely abolished.
Primary Outcome Measures
NameTimeMethod
Shivering response rate (%)10 minutes

complete cessation of shivering activity within 10 minutes after study drug injection

Secondary Outcome Measures
NameTimeMethod
sedation6 hours after study drug injection

using an Observer's Assessment of Alertness/Sedation Scale (OAA/SS) (where 5 = Responds readily to name spoken in normal tone, 4 = Lethargic response to name spoken in normal tone, 3 = Responds only after name is spoken loudly and/or repeatedly, 2 = Responds only after mild prodding or shaking, 1 = Does not respond to mild prodding or shaking).

Postoperative adverse events24 hours postoperative

postoperative nausea and vomiting, urine retention, post dural puncture headache ect.

Systolic blood pressure6 hours after study drug injection

find for systolic hypotension, hypertension

peripheral arterial saturation6 hours after study drug injection

find for hypoxia

diastolic blood pressure6 hours after study drug injection

find for diastolic hypertension or hypotension

Trial Locations

Locations (1)

Assiut university hospital, Assiut, Egypt

🇪🇬

Assiut, Assiut governorate, Egypt

© Copyright 2025. All Rights Reserved by MedPath