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Randomized Controlled Trial
. 2022 Aug 3;58(8):1046.
doi: 10.3390/medicina58081046.

Prevention of Shivering Post Subarachnoid Block: Comparison between Different Doses of Intravenous Magnesium Sulphate

Ren Geng Low  1 , Azarinah Izaham  1 , Jaafar Md Zain  1 , Nadia Md Nor  1 , Hsueh Jing Low  1 , Aliza Mohamad Yusof  1
Affiliations
Randomized Controlled Trial

Prevention of Shivering Post Subarachnoid Block: Comparison between Different Doses of Intravenous Magnesium Sulphate

Ren Geng Low et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Shivering is a common complication of subarachnoid block (SAB). Magnesium sulphate has been proven to be effective in preventing shivering. The aim of this study was to compare the effectiveness and adverse effects in hemodynamic parameters between 50 mg/kg and 30 mg/kg of intravenous magnesium sulphate for prevention of shivering post-subarachnoid block. Materials and Methods: Eighty-six patients scheduled for surgery under SAB, aged between 18 to 65 years old with American Society of Anesthesiologists physical status I and II were randomised into two groups. Group A received a bolus of 50 mg/kg, while Group B received 30 mg/kg of intravenous magnesium sulphate, given over a 20 min duration following SAB. Shivering grade was recorded intraoperatively according to the Crossley and Mahajan shivering scale. Mean arterial pressure (MAP), heart rate, tympanic temperature, oxygen saturation and the use of vasopressors were recorded. Results: Forty-five percent of patients in Group A and 20% of patients in Group B did not exhibit shivering (p-value < 0.01). High-grade shivering was observed in 12.5% in Group A and 40% in Group B, respectively (p-value 0.02). The MAP trend was lower in Group B (p-value < 0.01), but the incidence of hypotension was not significant in both groups. The use of vasopressors was also similar between groups. Group B showed a lower oxygen saturation trend (p-value 0.04). The trends of heart rate and tympanic temperature were not significant in both groups. No patients had episodes of bradycardia or oxygen desaturation. Conclusions: In this study, intravenous magnesium sulphate 50 mg/kg is the lowest effective dose for prevention and treatment of high-grade shivering post-SAB without significant hemodynamic adverse events.

Keywords: magnesium sulphate; prevention; shivering; subarachnoid block.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Trend of MAP, p = 0.008; * p < 0.05 (intragroup comparison with baseline MAP).
Figure 2
Figure 2
Trend of oxygen saturation, p = 0.040; * p < 0.05 (intragroup comparison with baseline MAP).
Figure 3
Figure 3
Trend of heart rate, p = 0.150.
Figure 4
Figure 4
Trend of core temperature, p = 0.634.
See this image and copyright information in PMC

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References

    1. Shukla U., Malhotra K., Prabhakar T. A comparative study of the effect of clonidine and tramadol on post-spinal anaesthesia shivering. Indian J. Anaesth. 2011;55:242–246. doi: 10.4103/0019-5049.82666. - DOI - PMC - PubMed
    1. Lopez M.B. Postanaesthetic shivering—From pathophysiology to prevention. Rom. J. Anaesth. Intensive Care. 2018;25:73–81. doi: 10.21454/rjaic.7518.251.xum. - DOI - PMC - PubMed
    1. De Witte J., Sessler D.I. Perioperative shivering: Physiology and pharmacology. Anesthesiology. 2002;96:467–484. doi: 10.1097/00000542-200202000-00036. - DOI - PubMed
    1. Abdelrahman A.S. Magnesium sulphate vsersus meperidine for prevention of shivering in patients scheduled for elective orthopedic surgery under spinal anesthesia. AAMJ. 2010;8:174–183.
    1. Luggya T.S., Kabuye R.N., Mijumbi C., Tindimwebwa J.B., Kintu A. Prevalence, associated factors and treatment of post spinal shivering in a Sub-Saharan tertiary hospital: A prospective observational study. BMC Anesthesiol. 2016;16:100. doi: 10.1186/s12871-016-0268-0. - DOI - PMC - PubMed

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