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Randomized Controlled Trial
. 2013 Aug 13;10(10):1327-32.
doi: 10.7150/ijms.6531. eCollection 2013.

Optimal dose of prophylactic dexmedetomidine for preventing postoperative shivering

Yong-Shin Kim  1 , Yong-Il Kim, Kwon-Hui Seo, Hye-Rim Kang
Affiliations
Randomized Controlled Trial

Optimal dose of prophylactic dexmedetomidine for preventing postoperative shivering

Yong-Shin Kim et al. Int J Med Sci. .

Abstract

Objective: The aim of this study was to investigate the optimum dosage of dexmedetomidine for prevention of postanesthetic shivering.

Methods: One-hundred thirty two ASA physical status I-II patients scheduled for elective laparoscopic total hysterectomy were enrolled in this randomised, placebo-controlled study. Patients were randomly allocated to receive dexmedetomidine in four groups: group S (0.9% normal saline), group D0.5 (dexmedetomidine 0.5 µg/kg), group D0.75 (dexmedetomidine 0.75 µg/kg), group D1.0 (dexmedetomidine 1.0 µg/kg). Time to extubation and tympanic temperature during and after operation were measured. Shivering was graded (0-3 scale) upon patients arrival to the PACU and every ten minutes thereafter up to forty minutes. Sedation and first rescue analgesic time at the PACU were evaluated.

Results: The incidence of shivering was significantly lower in group D0.75 and D1.0 than in group S (P < 0.05). There were significantly fewer patients with a shivering score of 2 or 3 in groups D0.75 and D1.0 than in group S (P < 0.05, P < 0.001). Extubation time was shorter in group S than in groups D0.75 and D1.0 (P < 0.05). Tympanic temperature at 40 minutes postoperatively in the recovery room was higher in group S than in the other dexmedetomidine groups (P < 0.05) Fewer patients required rescue analgesia in groups D0.75 and D1.0 than in group S (P < 0.001), and the time to rescue analgesia was longer in group D1.0 than in group S (P < 0.001). Modified Observer's Assessment of Alertness/Sedation (MOAA/S) at arrival in the PACU was lower in all dexmedetomidine groups than in group S (P < 0.05).

Conclusions: Our results suggest that dexmedetomidine 0.75 or 1.0 µg/kg provides effective prophylaxis against postoperative shivering as well as an analgesic effect. Though potential for intraoperative requirement for atropine, sedation in the immediate recovery period and delayed extubation time with dexmedetomidine was noted, there were no major clinical impacts on the overall recovery from anesthesia.

Keywords: dexmedetomidine; postanesthetic shivering.; sedation.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

References

    1. Buggy DJ, Crossley AW. Thermoregulation, mild perioperaitve hypothermia and postanaesthetic shivering. Br J Anaesth. 2000;84:615–28. - PubMed
    1. Macario A, Weinger M, Carney S. et al. Which clinical anesthesia outcomes are important to avoid? The perspective of patients. Anesth Analg. 1999;89:652–8. - PubMed
    1. Macintyre PE, Pavlin EB, Dwersteg JF. Effect of meperidine on oxygen consumption, carbon dioxide production, and respiratory gas exchange in postanesthesia shivering. Anesth Analg. 1987;66:751–5. - PubMed
    1. Frank SM, Fleisher LA, Olson KF. et al. Multivariate determinants of early postoperative oxygen comsumption in elderly patients. Effect of shivering, body temperature, and gender. Anesthesiology. 1995;83:241–9. - PubMed
    1. Singh P, Dimitriou V, Mahajan RP. et al. Double-blind comparison between doxapram and pethidine in the treatment of postanaesthetic shivering. Br J Anaesth. 1993;71:685–8. - PubMed

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