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Dexmedetomidine and postoperative shivering in patients undergoing elective abdominal hysterectomy

Published online by Cambridge University Press:  01 May 2008

E. G. Elvan ,
B. Öç ,
Ş. Uzun ,
E. Karabulut ,
F. Coşkun  and
Ü. Aypar
E. G. Elvan
Affiliation:
Hacettepe University, Faculty of Medicine, Department of Anaesthesiology and Reanimation, Sıhhıye, Ankara, Turkey
B. Öç
Affiliation:
Hacettepe University, Faculty of Medicine, Department of Anaesthesiology and Reanimation, Sıhhıye, Ankara, Turkey
Ş. Uzun*
Affiliation:
Hacettepe University, Faculty of Medicine, Department of Anaesthesiology and Reanimation, Sıhhıye, Ankara, Turkey
E. Karabulut
Affiliation:
Hacettepe University, Faculty of Medicine, Department of Biostatistics, Sıhhıye, Ankara, Turkey
F. Coşkun
Affiliation:
Hacettepe University, Faculty of Medicine, Department of Anaesthesiology and Reanimation, Sıhhıye, Ankara, Turkey
Ü. Aypar
Affiliation:
Hacettepe University, Faculty of Medicine, Department of Anaesthesiology and Reanimation, Sıhhıye, Ankara, Turkey
*
Department of Anaesthesiology and Reanimation, Faculty of Medicine, Hacettepe University, 06100 Sıhhıye, Ankara, Turkey. E-mail: [email protected]; Tel: +90 312 305 12 50; Fax: +90 312 310 96 00
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Summary

Background

Post-anaesthetic shivering is one of the most common complications, occurring in 5–65% of patients recovering from general anaesthesia and 33% of patients receiving epidural anaesthesia. Our objective was to investigate the efficacy of intraoperative dexmedetomidine infusion on postoperative shivering.

Methods

Ninety female patients, ASA I-II, 35–60 yr old, scheduled for elective total abdominal hysterectomy with or without bilateral salpingo-oophorectomy were randomized into two groups. After endotracheal intubation one group received normal saline infusion and the other received dexmedetomidine as a loading dose of 1 μg kg−1 for 10 min followed by a maintenance infusion of 0.4 μg kg−1 h−1. In the recovery room, pain was assessed using a 100 mm visual analogue scale and those patients who had a pain score of more than 40 mm were administered 1 mg kg−1 intramuscular diclofenac sodium. Patients with shivering grades more than 2 were administered 25 mg intravenous meperidine. Patients were protected with passive insulation covers.

Results

Post-anaesthetic shivering was observed in 21 patients in the saline group and in seven patients in the dexmedetomidine group (P = 0.001). Shivering occurred more often in the saline group. The Ramsay Sedation Scores were higher in the dexmedetomidine group during the first postoperative hour. Pain scores were higher in the saline group for 30 min after the operation. The need for intraoperative atropine was higher in the dexmedetomidine group. Intraoperative fentanyl use was higher in the saline group. Perioperative tympanic temperatures were not different between the groups whereas postoperative measurements were lower in the dexmedetomidine group (P < 0.05).

Conclusion

Intraoperative dexmedetomidine infusion may be effective in the prevention of post-anaesthetic shivering.

Keywords

ANAESTHESIA GENERALSHIVERINGSURGERY GYNAECOLOGICALDEXMEDETOMIDINEPOSTOPERATIVE PERIOD
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue 5 , May 2008 , pp. 357 - 364
Copyright
Copyright © European Society of Anaesthesiology 2008

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