NCT06711913

Role of Intravenous Dexmedetomidine in Reducing Shivering After Shivering Cesarean Section Due to Spinal Anesthesia

Effects of Intravenous Dexmedetomidine on Shivering After Cesarean Delivery Under Neuraxial Anesthesia - A Randomized Control Trial

• Status: Completed
• Phase: Phase 2
• Study type: Interventional
• Enrollment: 60 (actual)
• Sponsor: Liaquat National Hospital & Medical College · Academic / Other
• Sex: Female
• Age: 18 Years – 35 Years
• Healthy volunteers: Accepted

Summary

"After spinal anesthesia, some patients may experience shivering, which can be uncomfortable and even lead to complications. Dexmedetomidine is a medication that can help prevent or reduce this shivering. Dexmedetomidine helps to: 1. Reduces shivering and discomfort. 2. Improves patient comfort and satisfaction. 3. Regulates body temperature. 4. Safe and effective.

Detailed description

Post-spinal shivering is a common complication that occurs in 40-65% of patients undergoing spinal anesthesia. It is characterized by involuntary, rhythmic muscle contractions that can lead to discomfort, anxiety, and increased oxygen consumption. The exact mechanisms underlying post-spinal shivering are not fully understood, but several factors contribute to its development: 1. \*Hypothermia\*: Spinal anesthesia can cause a decrease in core body temperature, leading to shivering. 2. \*Sympathetic blockade\*: Spinal anesthesia blocks sympathetic nerve fibers, causing vasodilation and decreased blood flow to the extremities. 3. \*Increased oxygen consumption\*: Shivering increases oxygen consumption, which can be detrimental in patients with pre-existing cardiovascular or respiratory disease. \*Effects of Dexmedetomidine on Post-Spinal Shivering\* Dexmedetomidine, an alpha-2 adrenergic agonist, has been shown to effectively reduce post-spinal shivering. Its effects include: 1. \*Decreased shivering intensity\*: Dexmedetomidine reduces the severity of shivering, making patients more comfortable. 2. \*Increased core body temperature\*: Dexmedetomidine helps to maintain core body temperature, reducing the likelihood of hypothermia-induced shivering. 3. \*Reduced oxygen consumption\*: By decreasing shivering, dexmedetomidine reduces oxygen consumption, which is beneficial for patients with cardiovascular or respiratory disease. 4. \*Improved patient comfort\*: Dexmedetomidine's sedative and anxiolytic effects contribute to improved patient comfort and satisfaction. 5. \*Reduced need for other anti-shivering interventions\*: Dexmedetomidine's effectiveness in reducing post-spinal shivering may reduce the need for other interventions, such as meperidine, clonidine, or forced-air warming. Dexmedetomidine's anti-shivering effects are thought to be mediated by its actions on the following mechanisms: 1. \*Alpha-2 adrenergic receptors\*: Dexmedetomidine activates alpha-2 adrenergic receptors, which decreases sympathetic outflow and reduces shivering. 2. \*Hypothalamic thermoregulation\*: Dexmedetomidine may affect the hypothalamus, the body's thermoregulatory center, to reduce shivering and maintain core body temperature. 3. \*Spinal cord mechanisms\*: Dexmedetomidine may also act on the spinal cord to reduce shivering, possibly by inhibiting the release of excitatory neurotransmitters.

Conditions

• Shivering

Interventions

Type	Name	Description
DRUG	Dexmedetomidine	intravenous dexmedetomidine given in form of 100ml infusion over 10 minutes
OTHER	Normal Saline (Placebo)	control group receive normal saline as placebo

Timeline

• Start date: 2023-12-21
• Primary completion: 2024-06-15
• Completion: 2024-06-21
• First posted: 2024-12-02
• Last updated: 2024-12-02

Locations

1 site across 1 country: Pakistan