The effects of novel α2-adrenoreceptor agonist dexmedetomidine on shivering in patients underwent caesarean section

Gaofeng Yu, Shangyi Jin, Jinghui Chen, Weifeng Yao, Xingrong Song, Gaofeng Yu, Shangyi Jin, Jinghui Chen, Weifeng Yao, Xingrong Song

Abstract

Objective: Meperidine used to control shivering during perioperative period has associated side effects. The present study compared the safety of selective α2-adrenoreceptor agonist dexmedetomidine and meperidine for anti-shivering in primiparas after caesarean delivery under combined spinal-epidural anesthesia (CSEA).Methods: 100 primiparas scheduled for caesarean delivery were randomly allocated to dexmedetomidine group (Group D, n=50) and meperidine positive control group (Group M, n=50). Primiparas experienced shivering that continued to cord clamping were treated with dexmedetomidine (0.5 μg/kg) or meperidine (0.5 mg/kg) after cord clamping. The primary outcome measures were incidence of nausea, vomiting, and respiratory depression. Secondary outcome measures were shivering score, vital signs including blood pressure, heart rate and O2 saturation, tympanic temperature, and sedation score.Results: Dexmedetomidine provided similar anti-shivering effects as meperidine in patients after caesarean delivery under CSEA, evidenced as all shivering primiparas responded to either dexmedetomidine or meperidine treatment within 15 min. However, incidence of nausea and vomiting were significantly lower after dexmedetomidine treatment, accompanied with more stable blood pressure. Dexmedetomidine also provided well regulation of tympanic temperature and good sedation.Conclusion: Selective α2-adrenoreceptor agonist dexmedetomidine has a better safety profile compared with meperidine for anti-shivering in primiparas undergoing caesarean delivery. Dexmedetomidine could be a better choice for anti-shivering in patients requiring caesarean section. The mechanism of anti-shivering for dexmedetomidine may relate to well regulation of temperature and good sedation.

Keywords: caesarean delivery; combined spinal-epidural anesthesia; dexmedetomidine; meperidine; shivering.

Conflict of interest statement

The authors declare that there are no competing interests associated with the manuscript.

© 2019 The Author(s).

Figures

Figure 1. Flow chart of patients
Figure 1. Flow chart of patients
Figure 2. Change in blood pressure during…
Figure 2. Change in blood pressure during the study period
Blood pressure was monitored at the following time points: before (Tb) and after (Ta) CSEA, cord clamping (Tc), 0 min (T0), 5 min (T5), 10 min (T10), 15 min (T15), 20 min (T20), and 30 min (T30) after administration of dexmedetomidine or meperidine. (A) Pmean, (B) SBP, (C) DBP. *Compared with Group M, P<0.05. Group D means patients received dexmedetomidine treatment during caesarean section. Group M means patients received meperidine treatment during caesarean section.
Figure 3. Change in HR and SpO…
Figure 3. Change in HR and SpO2 during the study period
HR and SpO2 were monitored at the following time points: before (Tb) and after (Ta) CSEA, cord clamping (Tc), 0 min (T0), 5 min (T5), 10 min (T10), 15 min (T15), 20 min (T20), and 30 min (T30) after administration of dexmedetomidine or meperidine. (A) HR and (B) O2 saturation (SpO2). *Compared with Group M, P<0.05. Group D means patients received dexmedetomidine treatment during caesarean section. Group M means patients received meperidine treatment during caesarean section.
Figure 4. Change in tympanic temperature during…
Figure 4. Change in tympanic temperature during the study period
Tympanic temperature was monitored at the following time points: before (Tb) and after (Ta) CSEA, cord clamping (Tc), 0 min (T0), 5 min (T5), 10 min (T10), 15 min (T15), 20 min (T20), and 30 min (T30) after administration of dexmedetomidine or meperidine. (A) Patients tympanic temperature. (B) Patients sedation score. *Compared with T10, P<0.05; #compared with Group M, P<0.05. Group D means patients received dexmedetomidine treatment during caesarean section. Group M means patients received meperidine treatment during caesarean section.
Figure 5. Schematic diagram of selective α…
Figure 5. Schematic diagram of selective α2-adrenoreceptor agonist dexmedetomidine for anti-shivering in primiparas undergoing caesarean delivery under CSEA
Dexmedetomidine provided anti-shivering effects in patients after caesarean delivery under CSEA. Moreover, incidence of nausea and vomiting were significantly lower after dexmedetomidine treatment, accompanied with more stable blood pressure. Dexmedetomidine also provided well regulation of tympanic temperature and good sedation.

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Source: PubMed

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