Prophylactic administration of dexmedetomidine for prevention of shivering during spinal Anaesthesia

Background: Shivering is a frequent and distressing complication of spinal anaesthesia. Various drugs and physical methods are used to control shivering. Among pharmacological interventions, dexmedetomidine, a congener of clonidine, is a highly selective α2 adrenoreceptor agonist found to be effective in controlling shivering. The aim of this study is to evaluate the effect of the prophylactic administration of dexmedetomidine for prevention of shivering during spinal anaesthesia. Materials and Methods: A prospective, randomised and double-blind study was conducted among patients from either gender, aged 20–60 years, of American Society of Anesthesiologists (ASA) grade I or II who were scheduled for various surgeries under spinal anaesthesia. The patients were randomly divided into two groups of 60 each to receive either dexmedetomidine (Group D) 0.5 μg/kg or saline (Group S) immediately after spinal anaesthesia. Intraoperative incidence and grade of shivering, level of sedation, hemodynamic parameters and adverse reactions such as nausea and vomiting were recorded. Results: Seventeen patients in group S (28.3%) and 8 (13.3%) patients in group D experienced shivering (P = 0.043). Three patients in group S (3.3%) and 4 patients in group D (6.6%) had bradycardia (P = 0.69). Five patients in group S (8.3%) and 8 patients in group D (13.3%) had hypotension (P = 0.378). No patients in either group experienced nausea or vomiting. Conclusion: Prophylactic administration of dexmedetomidine significantly reduced shivering associated with spinal anaesthesia without any major adverse effect. Therefore, we conclude that dexmedetomidine infusion is an effective drug for preventing shivering and providing sedation in patients during spinal anaesthesia.