Dexmedetomidine in Post Spinal Anesthesia Shivering

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.

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