A Comparative Study of Intravenous Dexmedetomidine and Intravenous Clonidine for Postspinal Shivering in Patients Undergoing Lower Limb Orthopedic Surgeries

Abstract

Background: Dexmedetomidine and clonidine have been used for the prevention and treatment of shivering following spinal blockade. A prospective randomized, double-blinded study was conducted to compare the efficacy and safety of dexmedetomidine and clonidine in controlling postspinal shivering.

Methods: A total of sixty participants of equal sex, aged between 18 and 60 years of American Society of Anesthesiologists (ASA) I/II Class, who underwent orthopedic lower limb surgeries under spinal anesthesia with ≥Grade III shivering were randomly divided into two groups, Group D (n = 30) received injection dexmedetomidine 0.5 μg/kg and Group C (n = 30) received injection clonidine 1 μg/kg when they experienced shivering. Time taken to control shivering, response rate, recurrence rate, and side effects such as nausea, vomiting, dry mouth, respiratory depression, and deep sedation were observed.

Results: The demographic profile, ASA Class, duration of surgery, duration of anesthesia, temperature, onset and grade of shivering were all comparable between the two groups. Time taken to control shivering and recurrence rate were significantly lower in Group D when compared with Group C. Level of sedation was adequate with Group D, and the incidence of hypotension and bradycardia were significantly higher in Group C. The other side effects profiles were comparable between the two groups.

Conclusion: Dexmedetomidine 0.5 μg/kg is more efficient than clonidine 1 μg/kg in controlling postspinal blockade shivering. Dexmedetomidine has early onset of effect, high response rate, and less recurrence rate with added advantage of good sedation and stable cardiorespiratory parameters.

Keywords: Clonidine; dexmedetomidine; lower limb surgeries; postspinal shivering.

Figure 1

Comparison of sedation levels between the two groups.