Comparison of three different doses of dexmedetomidine for prevention of postspinal anesthesia shivering in transurethral resection of prostate surgery

摘要

Background and Aims: Postanesthetic shivering (PAS) is an unpleasant and potentially serious complication. It is often neglected, and no universal protocols are established for its prevention. The efficacy of dexmedetomidine for the treatment and prevention of PAS is well demonstrated. Very few studies have been done regarding the optimal effective dose of dexmedetomidine for the prevention of postspinal anesthesia (SA) shivering. Thus, we aimed to compare and evaluate three different doses of intravenous dexmedetomidine and to investigate the optimum dose of dexmedetomidine that effectively prevents shivering in patients undergoing transurethral resection of the prostate (TURP). Methods: In this randomized, double-blind, prospective study, 150 patients of the American Society of Anesthesiologists I and II scheduled for elective TURP under SA were enrolled. Patients were randomly allocated into one of the three groups receiving dexmedetomidine: Group P: 0.5 μg/kg, Group Q: 0.75 μg/kg, and Group R: 1.0 μg/kg. The primary outcome of the study was intraoperative incidence of shivering. The secondary outcomes, such as hemodynamic parameters and adverse reactions, were also noted. Results: Shivering score of different groups revealed statistically significant lower incidence and severity of shivering in Group Q and Group R when compared to Group P ( P = 0.0395). Incidences of nausea/vomiting, bradycardia, and hypotension were more in Group R when compared to Group P and Group Q. Axillary temperature and sedation scores were comparable among different groups ( P 0.05). Conclusion: Dexmedetomidine in the dose of 0.75 μg/kg provides adequate antishivering effect with added benefit of sedation and less hemodynamic instability.