Post Spinal Anesthesia Shivering
Conditions
Brief summary
Prevention of post spinal anesthesia shivering during cesarean section with its associated discomfort, distress, aggravation of pain, increased metabolic demands, and increased oxygen consumption
Detailed description
Shivering is one of the most important periperative complications seen in clinical practice. Several mechanisms have been postulated for its pathogenesis. Anesthetic-induced inhibition of thermoregulation resulting in hypothermia is an important cause of post anesthesia shivering, uncontrolled spinal reflexes, and cutaneous vasodilation are the other suggested mechanisms involved in the pathogenesis of shivering. Opioid receptors, α2 receptors, and serotonergic receptors also are involved of shivering. Various drugs were studied for their potential role in prevention of peri-operative shivering such as tramadol, dexmedetomidine, ondansetron, ketamine, and pethidine. We decided to perform a well-designed study to compare clonidine and granisetron which has been recently introduced as drugs for prevention and control of shivering after spinal anesthesia.
Interventions
intravenous Clonidine 0.5 µg/kg diluted in 10ml normal saline 20 minutes before spinal anesthesia
intravenous 1mg of granisetron diluted in 10ml normal saline 20 minutes before spinal anesthesia.
intravenous 10 ml normal saline 20 minutes before spinal anesthesia
Sponsors
Zagazig University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Masking description
triple blinded
Eligibility
Sex/Gender
FEMALE
Age
21 Years to 40 Years
Healthy volunteers
Yes
Inclusion criteria
Patient acceptance.,Aged between 21-40 years old, BMI: 18- 30 kg/m2, ASA: I and II., Scheduled for elective cesarean section under spinal anesthesia. \-
Exclusion criteria
History of hypersensitivity to drugs used in this study,Patients with history of chronic pain and taking analgesics, Patients with sepsis and Significant cardiac, liver or renal diseases, Uncooperative patients or with psychiatric disorders that prevent surgery under spinal anesthesia, Atrio-ventricular block in any degree, cardiac arrhythmias, valvular heart disease, kidney or liver diseases, neuromuscular disorders and diabetes mellitus \-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of Shivering | Procedure (through out the period of spinal anesthesia) | • Shivering will be graded according to Tsai and Chu scale (10): 0 = no shivering, 1 = piloerection or peripheral vasoconstriction but no visible shivering, 2 = muscular activity in only one muscle group, 3 = muscular activity in more than one muscle group but not generalized shivering, 4 =shivering involving the whole body |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| core body temperature | Procedure (preoperative as base and through out the period of spinal anesthesia) | Core body temperature was detected by measuring tympanic membrane temperature using digital infrared ear thermometer (thermoscan KFT-10; Grnzia, genova, Italy). |
| Maternal Heart rate | Procedure (preoperative as base and through out the period of spinal anesthesia) | beats/minute |
| baby APGAR score | 1 minutes and 5 minutes post natal | — |
| maternal blood presure | Procedure (preoperative as base and through out the period of spinal anesthesia) | mmhg |
Other
| Measure | Time frame |
|---|---|
| maternal oxygen saturation | Procedure (preoperative as base and through out the period of spinal anesthesia) |
Countries
Egypt
Contacts
Primary ContactHeba M Fathi, M.D
Outcome results
None listed