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 .
Prevention of hypotension and prolongation of postoperative analgesia in emergency cesarean sections: A randomized study with intrathecal clonidine
Background and Context : Different adjuvants been tried out for neuraxial anesthesia in emergency caesarean section so that the dose of the local anesthetic can be reduced and hypotension thereby prevented . Aims and Objectives : The present study was carried out in patients presenting for emergency lower segment caesarean section ( LSCS ) to establish the dose of intrathecal clonidine that would allow reduction of the dose of local anesthetic ( thereby reducing the incidence and magnitude of hypotension ) while at the same time providing clinical ly relevant prolongation of spinal anesthesia without significant side effects . Material s and Methods : This r and omized clinical study was carried out in our institution among 100 pregnant females who underwent emergency caesarean section .  The participants were divided r and omly into four groups : A , B , C , and D , each comprising 25 parturients . Subarachnoid block was performed using a 26 G Quincke needle , with 12 mg of hyperbaric bupivacaine ( LA ) in group A , 9 mg of LA + 30 μg of clonidine in group B , LA + 37.5 μg of clonidine in group C , and LA + 45 μg of clonidine in group D. The solution was uniformly made up to 2.2 mL with normal saline in all the groups . Onset of analgesia at T10 level , sensory and motor blockade levels , maternal heart rate and blood pressure , neonatal Apgar scores , postoperative block characteristics , and adverse events were looked for and recorded . Statistical analysis was carried out with SPSS ® version 10.0 for Windows ® , using the ANOVA test with post hoc significance , the Chi-square test , and the Mann-Whitney U test . P<.05 was considered significant and P<.0001 as highly significant . Results : One hundred patients were enrolled for this study . The four groups were comparable with regard to demographic data and neonatal Apgar scores . Onset and establishment of sensory and motor analgesia was significantly shorter in groups C and D , while hypotension ( and the use of vasopressors ) was significantly higher in groups A and D. Perioperative shivering , nausea , and vomiting were significantly higher in groups A and D , while incidence of dry mouth was significantly higher in group D. Conclusions : The addition of 45 μg , 37.5 μg , and 30 μg of clonidine to hyperbaric bupivacaine results in more prolonged complete and effective analgesia , allowing reduction of up to 18 % of the total dose of hyperbaric bupivacaine . From the results of this study , 37.5 μg of clonidine seems to be the optimal dose
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 .