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A Comparative Study to Evaluate the Efficacy of Intravenous Dexmedetomidine versus Clonidine for Post Spinal Anaesthesia Shivering in Caesarean Section

Vigy Varghese , Ramachandraiah R1 , Vigy Varghese2

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Indian Journal of Anesthesia and Analgesia 7(6):p 1309-1314, November-December 2020. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7620.63

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Ramachandraiah R, Vigy Varghese. A Comparative Study to Evaluate the Efficacy of Intravenous Dexmedetomidine versus Clonidine for Post Spinal Anaesthesia Shivering in Caesarean Section. Indian J Anesth Analg. 2020;7(6):1309–1314.

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Received : N/A         Accepted : N/A          Published : N/A

Abstract

Background: Lower segment caesarean section is widely performed under spinal anaesthesia and shivering is a common complication encountered. Clonidine and Dexmedetomidine are  – 2 agonists with anti-shivering property.

Aim: The aim was to compare the efficacy, hemodynamic and adverse effects of intravenous Dexmedetomidine versus Clonidine for post spinal anaesthesia shivering in LSCS.

Materials and Methods: A randomized double blind study was carried out in 70 parturients of ASA Physical Status II between 18 – 35 years who underwent LSCS under spinal anaesthesia and developed grade 2 or above level of shivering (wrench grading) in the intraoperative period. Group C (n=35) received intravenous Clonidine 1 mcg/kg and Group D (n=35) Dexmedetomidine 0.5 mcg/kg. Assessment included hemodynamics, time taken for complete cessation of shiveringand sedation scores.

Results: Mean time taken in Group D for cessation of shivering was 2.26 ± 0.44 minutes and in Group C, it was 5.48 ± 0.91min (p < 0.001). In Group C drug failed to control shivering in 17.4% and had recurrence in 20.69% while there was no failure (p < 0.001) and recurrence (p = 0.01) in Group D. Ramsay sedation scores were better with Group D when compared with Group C (p = 0.005). The incidence of hypotension and bradycardia was 22.8% in Group C and in Group D 2.86% (p = 0.012).

Conclusion: We conclude that Dexmedetomidine (0.5 mcg/kg) has early onset of action with less failure rate and recurrences with better hemodynamic stability and sedation when compared to Clonidine (1.0 mcg/kg) for post spinal shivering in LSCS

Keymessage: The study aimed to observe the efficacy of intravenous Dexmedetomidine versusClonidine for post spinal anaesthesia shivering in LSCS. The hemodynamic responses and sedationachieved by Dexmedetomidine and Clonidine when used as antishivering agent were also compared.
 

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Ramachandraiah R, Vigy Varghese. A Comparative Study to Evaluate the Efficacy of Intravenous Dexmedetomidine versus Clonidine for Post Spinal Anaesthesia Shivering in Caesarean Section. Indian J Anesth Analg. 2020;7(6):1309–1314.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7620.63

Keywords

Shivering; Caesarean section; Spinal anaesthesia; Clonidine; Dexmedetomidine.

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