A prospective, randomized clinical trial for comparison of pethidine and dexmedetomidine for the control of intraoperative shivering under spinal anaesthesia

Introduction: Pharmacological methods using variety of drugs like pethidine, morhine, tramadol, clonidine, doxapram, ketansarine, nefopam, neostigmine, magnesium sulfate have been tried in post spinal shivering. Aim of the present study was to compare the two drugs pethidine and dexmedetomidine for the control of intraoperative shivering under spinal anaesthesia. Materials and Methods: A prospective randomized study where total 80 patients of either gender aged between 20-60 years, ASA grade of I -II and patients who develop shivering of grade 2-3 (Crossley and Mahajan scale) after spinal anaesthesia were enclosed within the study after getting informed consent. The patients were randomized into two groups of 40 patients each. Group DDexmedetomidine group received single intravenous bolus dose of dexmeditomidine 0.5mcg/kg over 5 min. Group P -Pethidine group patients received 0.5mg/kg Pethidine IV over 5 min. The time was accurately noted in seconds from drug administration to the disappearance of shiv ering. Patients were monitored at intervals of 1 minute, 3min, 5min and thenceforth 10, 20 and 30 minutes until finish of surgery. Patients were intently monitored for failure of the drug, recurrence of shivering and side effects such as nausea, vomiting, bradycardia (<50/min), hypotension (>20% of baseline), giddiness and sedation score will be recorded. Chi-square test was accustomed to evaluate categorical factors. Results: Dexmedetomidine group had significant reduction in time needed to control shivering and disappearance of shivering after drug administration. Conclusion: Through this study we tend to found that the time taken for control of shivering was shorter with Dexmedetomidine as compared to Pethidine. Side effects were less with Dexmedetomidine as compared to Pethidine. Introduction Spinal anaesthesia is widely used as a safe anaesthetic technique for both elective and emergency surgeries. Shivering is understood to be a frequent complication, reportable in 40 to 70% of patients undergoing surgery underneath regional anaesthesia. Shivering besides being physiologically stressful to the patient also causes unpleasant to the anesthesiologists and surgeons. Shivering can occur in patients receiving regional anaesthesia as well as those patients recovering from general anaesthesia. It causes several undesirable physiologic consequences including increase in oxygen consumption, hypercarbia and increase in minute ventilation. It induces arterial hypoxemia, lactic acidosis, increased intra-ocular pressure, intracranial pressure and interfere with patient monitoring. Shivering may negate orthopedic procedures like fractures and dislocations and may also cause damage to dental prosthesis. Various non-pharmacological and pharmacological methods are available for the control of shivering during anaesthesia. Fluid warmers, ambient operation theater temperature, space blankets, surgical drapes and active circulating water mattress are some of the non pharmacological methods. Pharmacological methods using various drugs like Tramadol Clonidine, Doxapram, Dexmedetomidine, Pethidine, Nefopam, Neostigmine, Magnesium sulphate have been tried. In the pursue a lot of safe and efficacious drug we tend to compared 2 effective and safe drugs Dexmedetomidine and Pethidine, intravenously administered for treating shivering in patients who received spinal anaesthesia for numerous surgical procedures. Our aim was to compare the efficacy of two drugs 0.5mcg/kg of Dexmedetomidine and 0.5mg/kg of Pethidine with respect to study time from drug administration to control of shivering, Recurrence of shivering after Article Info Received: 29th May, 2019 Accepted: 18th June, 2019 Published Online: 22nd August, 2019