The optimum dose of dexmedetomidine for shivering control with the least
hemodynamic derangements is still under research.
Objective: To compare the efficacy, hemodynamic and side effects of dexmedetomidine in 3
different doses with those of meperidine for the treatment of shivering in patients undergoing
spinal anesthesia for minor elective lower abdominal surgery.
Study Design: Prospective double-blind randomized clinically controlled study.
Setting: University hospital.
Methods: One hundred twenty patients who developed shivering under spinal anesthesia.
On shivering, patients were randomly allocated to receive an intravenous 2 mL bolus dose
of meperidine 0.4 mg/kg (meperidine group, n = 30), dexmedetomidine 0.5 μg/kg (DEX I
group, n = 30), 0.3 μg/kg (DEX II group, n = 30), or 0.2μg/kg (DEX III group, n = 30). Control
of shivering, time taken for cessation of shivering, response rate, recurrence, hemodynamic
changes, sedation score, tympanic temperature, and side effects were noted and compared
between groups.
Results: The groups were comparable regarding demographic profile, tympanic temperature
decline, and shivering onset time (P > 0.05). Lower shivering cessation time (P < 0.001) and
higher response rate (P < 0.01) were observed in DEX I and II groups compared with DEX III and
meperidine groups, with a nonsignificant difference between DEX I and II groups. Recurrence
of shivering activity was higher in DEX III group (36.7%, P < 0.01) compared with DEX I (10%),
DEX II (6.7%) and meperidine (16.7%) groups. Lower heart rates, systolic and diastolic blood
pressure mean values were recorded in DEX I group (P < 0.05). Nine patients (30%) in DEX I
group were in levels 3 – 5 of sedation (P < 0.02) compared with 5 (16.66%), 2 (6.66%), and 4
(13.3) patients in DEX II, DEX III, and meperidine groups, respectively.
Limitations: This study is limited by its small sample size.
Conclusions: Among the 3 doses investigated, dexmedetomidine 0.3μg/kg effectively
treated shivering associated with spinal anesthesia with modest hemodynamic and sedation
effects.
Trial Registration: ClinicalTrials.gov Identifier: NCT02382432.