A prospective, randomized clinical trial for comparison of pethidine and dexmedetomidine for the control of intraoperative shivering under spinal anaesthesia

Abstract

Introduction: Pharmacological methods using variety of drugs like pethidine, morhine, tramadol, clonidine, doxapram, ketansarine, nefopam, neostigmine, magnesium sulfate have been tried in post spinal shivering. Aim of the present study was to compare the two drugs pethidine and dexmedetomidine for the control of intraoperative shivering under spinal anaesthesia. Materials and Methods: A prospective randomized study where total 80 patients of either gender aged between 20-60 years, ASA grade of I -II and patients who develop shivering of grade 2-3 (Crossley and Mahajan scale) after spinal anaesthesia were enclosed within the study after getting informed consent. The patients were randomized into two groups of 40 patients each. Group D- Dexmedetomidine group received single intravenous bolus dose of dexmeditomidine 0.5mcg/kg over 5 min. Group P -Pethidine group patients received 0.5mg/kg Pethidine IV over 5 min. The time was accurately noted in seconds from drug administration to the disappearance of shivering. Patients were monitored at intervals of 1 minute, 3min, 5min and thenceforth 10, 20 and 30 minutes until finish of surgery. Patients were intently monitored for failure of the drug, recurrence of shivering and side effects such as nausea, vomiting, bradycardia (20% of baseline), giddiness and sedation score will be recorded. Chi-square test was accustomed to evaluate categorical factors. Results: Dexmedetomidine group had significant reduction in time needed to control shivering and disappearance of shivering after drug administration. Conclusion: Through this study we tend to found that the time taken for control of shivering was shorter with Dexmedetomidine as compared to Pethidine. Side effects were less with Dexmedetomidine as compared to Pethidine. Keywords: Pethidine, Dexmedetomidine, Spinal anaesthesia, Shivering.