Comparison of bolus administration with continuous infusion of intravenous magnesium sulfate in the prevention of Shivering following cesarean section under spinal anesthesia, a double-blind randomized clinical trial

Abstract

Introduction and Objectives: Considering high prevalence of shivering in cesarean section, various methods have been used to reduce and treat it. Magnesium sulfate is a common drug used in pregnant women that has anti Shivering properties. The aim of this study was to compare the efficacy of intravenous magnesium sulfate as bolus or continuous infusion in prevention of Shivering following cesarean section.Methods: This study was an interventional clinical trial that was performed on 300 pregnant women with term pregnancies, singleton, who underwent elective cesarean section under spinal anesthesia. Patients were divided into 3 groups who immediately after spinal anesthesia received 30-minute infusion of magnesium sulfate, bolus injection of magnesium sulfate and normal saline, respectively. Vital signs and severity of shivering, along with complications such as nausea and vomiting, decreased heart rate and hypotension, and decreased arterial oxygen saturation were recorded and data analyzed.Results: Shivering at 30, 60, 75 and 90 minutes was significantly lower in the magnesium sulfate infusion group within 30 minutes than in the bolus receiving and control groups (p = 0.018).Conclusion: The prevalence of shivering was significantly reduced by continuous Infusion of magnesium sulfate. In the administration of magnesium sulfate, infusion within 30 minutes had a significant advantage in reducing the incidence of Shivering and less side effects than bolus administration.