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Comparative study between Dexmedetomidine and Ondansteron for prevention of post spinal shivering. A randomized controlled trial.
BMC Anesthesiol. 2018 11 30; 18(1):179.BA

Abstract

BACKGROUND

Regional anesthesia could affect the homeostatic system functions resulting frequently in perioperative hypothermia and consequently shivering. The objective of this trial was to evaluate the efficacy of dexmedetomidine and ondansetron to reduce the incidence and severity of shivering after intrathecal blocks.

METHODS

This randomized placebo-controlled trial included 120 patients allocated equally in three groups. All patients were anesthetized by standard intrathecal blocks for surgical procedure at lower half of the body and received one of the study drugs intravenously (IV) according to the group assignments. Group S patients (placebo) were administered saline, Group O (ondansetron) were given 8 mg ondansetron, and Group D (dexmedetomidine) were given 1 μg/kg of dexmedetomidine. Shivering incidence and scores, sedation scores, core body temperature, hemodynamic variables, and incidence of complications (nausea, vomiting, hypotension, bradycardia, over-sedation, and desaturation) were recorded.

RESULTS

The incidence and 95% confidence interval (95% CI) of shivering in group S 57.5% (42.18-72.82%) was significantly higher than that of both group O 17.5% (5.73-29.27%), P < 0.001 and group D 27.5% (13.66-41.34%), P = 0.012. However, the difference in the incidence of shivering between group O and group D was comparable, P = 0.425. The sedation scores were significantly higher in group D than those of both group S and group O, P < 0.001. Sedation scores between group S and group O were comparable, P = 0.19. Incidences of adverse effects were comparable between the three groups.

CONCLUSION

Prophylactic administrations of dexmedetomidine or ondansetron efficiently decrease the incidence and severity of shivering after spinal anesthesia as compared to placebo without significant difference between their efficacies when compared to each other.

TRIAL REGISTRATION

Pan African Clinical Trial Registry (PACTR) under trial number (PACTR201710002706318). 18-10-2017. 'retrospectively registered'.

Authors+Show Affiliations

Department of Anesthesia, Fayoum University, Fayoum, Egypt. dr_jo27@yahoo.com.Department of Anesthesia, Fayoum University, Fayoum, Egypt.Department of Anesthesia, Fayoum University, Fayoum, Egypt.Department of Anesthesia, Fayoum University, Fayoum, Egypt.Department of Anesthesia, Ain Shams University, Cairo, Egypt.Department of Anesthesia, Fayoum University, Fayoum, Egypt.Department of Anesthesia, Fayoum University, Fayoum, Egypt.Department of Anesthesia, Fayoum University, Fayoum, Egypt.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30501612

Citation

Botros, Joseph Makram, et al. "Comparative Study Between Dexmedetomidine and Ondansteron for Prevention of Post Spinal Shivering. a Randomized Controlled Trial." BMC Anesthesiology, vol. 18, no. 1, 2018, p. 179.
Botros JM, Mahmoud AMS, Ragab SG, et al. Comparative study between Dexmedetomidine and Ondansteron for prevention of post spinal shivering. A randomized controlled trial. BMC Anesthesiol. 2018;18(1):179.
Botros, J. M., Mahmoud, A. M. S., Ragab, S. G., Ahmed, M. A. A., Roushdy, H. M. S., Yassin, H. M., Bolus, M. L., & Goda, A. S. (2018). Comparative study between Dexmedetomidine and Ondansteron for prevention of post spinal shivering. A randomized controlled trial. BMC Anesthesiology, 18(1), 179. https://doi.org/10.1186/s12871-018-0640-3
Botros JM, et al. Comparative Study Between Dexmedetomidine and Ondansteron for Prevention of Post Spinal Shivering. a Randomized Controlled Trial. BMC Anesthesiol. 2018 11 30;18(1):179. PubMed PMID: 30501612.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative study between Dexmedetomidine and Ondansteron for prevention of post spinal shivering. A randomized controlled trial. AU - Botros,Joseph Makram, AU - Mahmoud,Atef Mohamed Sayed, AU - Ragab,Safaa Gaber, AU - Ahmed,Mohammed Awad Alsaeid, AU - Roushdy,Hany Maher Salib, AU - Yassin,Hany Mahmoud, AU - Bolus,Maged Labib, AU - Goda,Abeer Shaban, Y1 - 2018/11/30/ PY - 2018/01/13/received PY - 2018/11/16/accepted PY - 2018/12/4/entrez PY - 2018/12/7/pubmed PY - 2019/8/3/medline KW - Dexmedetomidine KW - Intraoperative hypothermia KW - Ondansetron KW - Shivering KW - Spinal anesthesia SP - 179 EP - 179 JF - BMC anesthesiology JO - BMC Anesthesiol VL - 18 IS - 1 N2 - BACKGROUND: Regional anesthesia could affect the homeostatic system functions resulting frequently in perioperative hypothermia and consequently shivering. The objective of this trial was to evaluate the efficacy of dexmedetomidine and ondansetron to reduce the incidence and severity of shivering after intrathecal blocks. METHODS: This randomized placebo-controlled trial included 120 patients allocated equally in three groups. All patients were anesthetized by standard intrathecal blocks for surgical procedure at lower half of the body and received one of the study drugs intravenously (IV) according to the group assignments. Group S patients (placebo) were administered saline, Group O (ondansetron) were given 8 mg ondansetron, and Group D (dexmedetomidine) were given 1 μg/kg of dexmedetomidine. Shivering incidence and scores, sedation scores, core body temperature, hemodynamic variables, and incidence of complications (nausea, vomiting, hypotension, bradycardia, over-sedation, and desaturation) were recorded. RESULTS: The incidence and 95% confidence interval (95% CI) of shivering in group S 57.5% (42.18-72.82%) was significantly higher than that of both group O 17.5% (5.73-29.27%), P < 0.001 and group D 27.5% (13.66-41.34%), P = 0.012. However, the difference in the incidence of shivering between group O and group D was comparable, P = 0.425. The sedation scores were significantly higher in group D than those of both group S and group O, P < 0.001. Sedation scores between group S and group O were comparable, P = 0.19. Incidences of adverse effects were comparable between the three groups. CONCLUSION: Prophylactic administrations of dexmedetomidine or ondansetron efficiently decrease the incidence and severity of shivering after spinal anesthesia as compared to placebo without significant difference between their efficacies when compared to each other. TRIAL REGISTRATION: Pan African Clinical Trial Registry (PACTR) under trial number (PACTR201710002706318). 18-10-2017. 'retrospectively registered'. SN - 1471-2253 UR - https://www.unboundmedicine.com/medline/citation/30501612/Comparative_study_between_Dexmedetomidine_and_Ondansteron_for_prevention_of_post_spinal_shivering__A_randomized_controlled_trial_ L2 - https://bmcanesthesiol.biomedcentral.com/articles/10.1186/s12871-018-0640-3 DB - PRIME DP - Unbound Medicine ER -