Dexomedetomidine versus Ondansetron for Treatment of Post Spinal Shivering in Patients Undergoing Abdominal Hysterectomy: A Randomized Double Blind, Controlled Study
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- Category: Vol. 85, June 2017
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Dexomedetomidine versus Ondansetron for Treatment of Post Spinal Shivering in Patients Undergoing Abdominal Hysterectomy: A Randomized Double Blind, Controlled Study, TAMER M. KHAIR
Abstract
Background: Objective shivering is very distressing for the patient therefore, control of postspinal shivering is essential for proper perioperative care. This study was designed to compare the efficacy, safety and cost effectiveness of Dexme-detomidine and Ondansetron in the treatment of postspinal shivering.
Methods: In this prospective, randomized, double-blind, placebo controlled study, 75 American Society of Anesthesi-ologists Grade I and II females scheduled for abdominal hysterectomy under spinal anesthesia, who developed shivering grade 3 or 4 were included. The patients were randomized into three groups of 25 patients each to receive either on-dansetron 8mg/ml (Group O) or Dexmedetomidine 0.5mg/kg (Group D) or saline (Group C) as a slow intravenous bolus for treatment of shivering. Onset of shivering, grade of shivering, time for cessation, response rate, recurrence, he-modynamic parameters and adverse effects were observed at scheduled intervals.
Results: It was observed that the mean response time for control of shivering was significantly less in Group D (1.97± 0.61min) compared to Group O (3.56±0.82min) and Group C (12.4±3.74min). Success rate in Group D was 100% com-pared to 64% in Group O and 32% in Group C. Relapse of shivering was observed more in patients of Group O (16.7%) as compared to Group D (0%) while shivering reappeared in 75% of patients who responded to saline treatment. Among the side effects, sedation was found in both Group D. Brady-cardia and hypotension were more frequent in Dexmedetomi-dine group although none of the patients required treatment.
Conclusion: Both Ondansetron and Dexmedetomidine control shivering effectively, but Dexmedetomidine seems to be a better choice than Ondansetron for treatment of postspinal shivering due to its shorter response time, lower recurrence rate and associated sedation.