Prevention of post spinal anesthesia shivering during cesarean section with its associated discomfort, distress, aggravation of pain, increased metabolic demands, and increased oxygen consumption
Shivering is one of the most important periperative complications seen in clinical practice. Several mechanisms have been postulated for its pathogenesis. Anesthetic-induced inhibition of thermoregulation resulting in hypothermia is an important cause of post anesthesia shivering, uncontrolled spinal reflexes, and cutaneous vasodilation are the other suggested mechanisms involved in the pathogenesis of shivering. Opioid receptors, α2 receptors, and serotonergic receptors also are involved of shivering. Various drugs were studied for their potential role in prevention of peri-operative shivering such as tramadol, dexmedetomidine, ondansetron, ketamine, and pethidine. We decided to perform a well-designed study to compare clonidine and granisetron which has been recently introduced as drugs for prevention and control of shivering after spinal anesthesia.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
TRIPLE
Enrollment
186
intravenous Clonidine 0.5 µg/kg diluted in 10ml normal saline 20 minutes before spinal anesthesia
intravenous 1mg of granisetron diluted in 10ml normal saline 20 minutes before spinal anesthesia.
intravenous 10 ml normal saline 20 minutes before spinal anesthesia
Heba M Fathi
Zagazig, Egypt
RECRUITINGIncidence of Shivering
• Shivering will be graded according to Tsai and Chu scale (10): 0 = no shivering, 1 = piloerection or peripheral vasoconstriction but no visible shivering, 2 = muscular activity in only one muscle group, 3 = muscular activity in more than one muscle group but not generalized shivering, 4 =shivering involving the whole body
Time frame: Procedure (through out the period of spinal anesthesia)
core body temperature
Core body temperature was detected by measuring tympanic membrane temperature using digital infrared ear thermometer (thermoscan KFT-10; Grnzia, genova, Italy).
Time frame: Procedure (preoperative as base and through out the period of spinal anesthesia)
Maternal Heart rate
beats/minute
Time frame: Procedure (preoperative as base and through out the period of spinal anesthesia)
baby APGAR score
Time frame: 1 minutes and 5 minutes post natal
maternal blood presure
mmhg
Time frame: Procedure (preoperative as base and through out the period of spinal anesthesia)
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