Effects of intrathecal dexmedetomidine vs. magnesium sulfate on post-operative shivering for cesarean delivery: A double-blind randomized clinical trial
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Abstract
Background
Considering the similarities and differences between dexmedetomidine and magnesium sulfate and understanding their mechanisms of action on shivering and thermoregulation, the authors proposed to compare the effect of intrathecal administration of dexmedetomidine and magnesium sulfate on shivering intensity in patients undergoing cesarean delivery surgery.
Methods
This study is a randomized, double-blind clinical trial, with two intervention groups and a parallel design. Patients randomized to Group D received 5 µg of dexmedetomidine plus 12.5 mg bupivacaine, group M received 25 mg magnesium sulfate plus 12.5 mg bupivacaine, and group C received 12.5 mg bupivacaine plus 1 ml normal saline 0.9 %. Physiological symptoms were recorded in the checklist by a research associate (blinded to the treatment group). Shivering intensity was evaluated by Tsai and Chu method. Physiological symptoms, the shivering intensity were recorded before (0) and 20, 45, 55 and 65 min after spinal anesthesia.
Results
GEE analysis of the study data showed a significant difference in the severity of shivering between the group dexmedetomidine and the group magnesium sulfate at different times (intervals) (p-value<0.001). Additionally, significance difference was observed between group control and group dexmedetomidine (p-value<0.001). The results of second model demonstrates that the patient in magnesium sulfate group were significantly six times more likely to experience shivering compared to dexmedetomidine group (OR =5.69, 95 % CI: 1.71–22.91, p-value<0.01).
Conclusions
Dexmedetomidine has a greater effect than magnesium sulfate on reducing the incidence of shivering and its severity in patients undergoing cesarean delivery.
期刊介绍:
The objective of this new online journal is to serve as a multidisciplinary, peer-reviewed source of information related to the administrative, economic, operational, safety, and quality aspects of the ambulatory and in-patient operating room and interventional procedural processes. The journal will provide high-quality information and research findings on operational and system-based approaches to ensure safe, coordinated, and high-value periprocedural care. With the current focus on value in health care it is essential that there is a venue for researchers to publish articles on quality improvement process initiatives, process flow modeling, information management, efficient design, cost improvement, use of novel technologies, and management.