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Canadian Journal of Anesthesia/Journal canadien d'anesthésie
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 7/2019

01-07-2019 | Spinal Anesthesia | Reports of Original Investigations

Intravenous dexmedetomidine for the treatment of shivering during Cesarean delivery under neuraxial anesthesia: a randomized-controlled trial

Authors: Christina Lamontagne, MD, FRCP, Sandra Lesage, MD, FRCP, Edith Villeneuve, MD, FRCP, Elsa Lidzborski, MD, Alex Derstenfeld, BASc, BCL, LLB, Chantal Crochetière, MD, FRCP

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 7/2019

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Abstract

Purpose

About 55% of patients undergoing a Cesarean delivery under spinal or epidural anesthesia will experience shivering, which may interfere with the monitoring of vital signs. Recent studies have shown that dexmedetomidine could potentially help to alleviate shivering associated with anesthesia. We investigated whether dexmedetomidine, an alpha 2-adrenergic agonist, reduces the duration of shivering associated with neuraxial anesthesia during Cesarean delivery.

Methods

Eighty parturients undergoing Cesarean delivery under neuraxial anesthesia and experiencing shivering were enlisted in this prospective, randomized, double-blind trial. After childbirth, the intervention group (n = 40) received a single intravenous bolus of dexmedetomidine (30 µg) while the control group (n = 40) received saline. Randomization and allocation were based on a computer-generated list. The primary outcome measure was the time required for an observable decrease in shivering after the intervention.

Results

One hundred fifty-five patients were recruited, 80 of whom presented with shivering and were randomized. Our study showed that dexmedetomidine reduced the mean (standard deviation) duration of shivering after a single intravenous bolus to 2.6 (2.1) min after dexmedetomidine from 17.9 (12.6) min after saline (difference in means, -15.3 min; 95% confidence interval [CI], -11.2 to -19.4). The effect of dexmedetomidine persisted 15 min after the bolus was administered, as shivering had completely stopped in 90% of the patients in the intervention group vs 22.5% in the control group (relative risk, 4.0; 95% CI, 2.2 to 7.2). No adverse effects, including bradycardia, were observed.

Conclusion

A single intravenous bolus of dexmedetomidine decreased the duration of shivering for up to 15 min during Cesarean delivery under neuraxial anesthesia.

Trial registration

www.clinicaltrials.gov (NCT02384343); registered 10 March, 2015.
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Metadata
Title
Intravenous dexmedetomidine for the treatment of shivering during Cesarean delivery under neuraxial anesthesia: a randomized-controlled trial
Authors
Christina Lamontagne, MD, FRCP
Sandra Lesage, MD, FRCP
Edith Villeneuve, MD, FRCP
Elsa Lidzborski, MD
Alex Derstenfeld, BASc, BCL, LLB
Chantal Crochetière, MD, FRCP
Publication date
01-07-2019
Publisher
Springer International Publishing
Published in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 7/2019
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-019-01354-3

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