The results showed that , compared with placebo , pethidine , fentanyl , dexmedetomidine , and sufentanil significantly reduced the incidence of perioperative shivering .
In addition , compared with sufentanil , fentanyl showed no impact on haemodynamic stability and the incidence of pruritus .
CONCLUSION Pethidine , fentanyl , dexmedetomidine , and sufentanil appear to be effective for preventing perioperative shivering in puerperae undergoing cesarean sections .
Considering the risk-benefit profiles of the included neuraxial adjuvants , fentanyl is probably the optimal choice
BACKGROUND Perioperative shivering is clinical ly common during cesarean sections under neuraxial anesthesia , and several neuraxial adjuvants are reported to have preventive effects on it .
However , the results of current studies are controversial and the effects of these neuraxial adjuvants remain unclear .
AIM To evaluate the effects of neuraxial adjuvants on perioperative shivering during cesarean sections , thus providing an optimal choice for clinical application .
Comparison of Intrathecal Dexmedetomidine with Morphine as Adjuvants in Cesarean Sections.
To compare the effects of intrathecal dexmedetomidine and intrathecal morphine as supplements to bupivacaine in cesarean sections under spinal anesthesia . Full-term parturients ( n=120 ) undergoing elective cesarean sections under spinal anesthesia were r and omly allocated into three groups : Group B received 10 mg bupivacaine , Group BD received 10 mg bupivacaine plus 5 µg dexmedetomidine , and Group BM received 10 mg bupivacaine plus 100 µg morphine .  The onset and regression time of sensory and motor blockade , postoperative analgesia , and side effects were recorded . Group BD showed quicker onset time and a longer sensory and motor blockade than other groups ( BD vs. B and BD vs. BM , p<0.05 ) . The mean time of sensory regression to the S1 segment was 253.21±42.79 min in group BD , 192.50±40.62 min in group BM and 188.33±37.62 min in group B ( p<0.001 ) . Group BD showed an analgesia duration ( time to requirement of first rescue analgesic ) ( 17.59±6.23 h ) similar to that of group BM ( 16.78±5.90 h ) but longer than that of group B ( 3.53±1.68 h ) ( p<0.001 ) . The incidence of pruritus was significantly higher in group BM compared with groups BD and B ( p<0.001 ) . Less shivering was observed in group BD than in groups BM and B ( p=0.009 ) . So intrathecal dexmedetomidine ( 5 µg ) prolonged the motor and sensory blockade , provided a similar analgesic effect and reduced pruritus and shivering compared with morphine ( 100 µg ) in cesarean sections
The results showed that , compared with placebo , pethidine , fentanyl , dexmedetomidine , and sufentanil significantly reduced the incidence of perioperative shivering .
In addition , compared with sufentanil , fentanyl showed no impact on haemodynamic stability and the incidence of pruritus .
CONCLUSION Pethidine , fentanyl , dexmedetomidine , and sufentanil appear to be effective for preventing perioperative shivering in puerperae undergoing cesarean sections .
Considering the risk-benefit profiles of the included neuraxial adjuvants , fentanyl is probably the optimal choice
BACKGROUND Perioperative shivering is clinical ly common during cesarean sections under neuraxial anesthesia , and several neuraxial adjuvants are reported to have preventive effects on it .
However , the results of current studies are controversial and the effects of these neuraxial adjuvants remain unclear .
AIM To evaluate the effects of neuraxial adjuvants on perioperative shivering during cesarean sections , thus providing an optimal choice for clinical application .