The Effect of Intrathecal Magnesium Sulfate on Shivering

NCT ID: NCT05427149

Last Updated: 2022-09-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-05-10

Study Completion Date

2022-08-30

Brief Summary

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Shivering after spinal anesthesia is a common complication. Mangesium sulfate, which can be used intrathecally, is effective in preventing tremor. But what is the ideal dose?

Detailed Description

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Perioperative shivering during cesarean section (CS) under neuraxial anesthesia (NA) is clinically common, but its treatment is often neglected.

When the literature is scanned, perioperative tremors are seen in 55%-60% of patients undergoing neuraxial anesthesia. However, the mechanism of the tremor has not been fully elucidated. Possible factors that can cause tremor can be listed as follows:

1. Loss of thermoregulatory vasoconstriction below the block level,
2. The displacement of body temperature from the central to the periphery due to vasodilation,
3. Increased sweating threshold and decreased peripheral vasoconstriction Perioperative shivering is a complication that needs to be treated because it causes dangerous consequences in patients with low cardiopulmonary reserve due to increased oxygen consumption and impairs patient and surgeon comfort.

Magnesium sulfate is one of the most effective adjuvant drugs with the least side-effect profile in the treatment of tremor after noxial block.

Conditions

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Magnesium Sulfate Causing Adverse Effects in Therapeutic Use Postoperative Shivering Cesarean Section Complications

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Group C

Patients receiving intrathecal 10 mg hyperbaric bupivacaine (Marcaine® Spinal Heavy %0.5, Sanofi, Kırklareli, Turkey) + 1 mL normal saline (Polifleks %0.9 İzotonik Sodyum Klorür, Polifarma, Ankara, Turkey)

Group Type ACTIVE_COMPARATOR

25 mg MgSO4 (Magnezyum Sulfat %15, Biofarma, Istanbul, Turkey)

Intervention Type DRUG

It will be evaluated whether there is postpinal shivering in the cases.

Group M25

Patients receiving intrathecal 10 mg hyperbaric bupivacaine (Marcaine® Spinal Heavy %0.5, Sanofi, Kırklareli, Turkey) + 25 mg MgSO4 (Magnezyum Sulfat %15, Biofarma, Istanbul, Turkey). MgSO4 diluted to 25mg/mL with normal saline (Polifleks %0.9 İzotonik Sodyum Klorür, Polifarma, Ankara, Turkey).

Group Type ACTIVE_COMPARATOR

25 mg MgSO4 (Magnezyum Sulfat %15, Biofarma, Istanbul, Turkey)

Intervention Type DRUG

It will be evaluated whether there is postpinal shivering in the cases.

Group M50

Patients receiving intrathecal 10 mg hyperbaric bupivacaine (Marcaine® Spinal Heavy %0.5, Sanofi, Kırklareli, Turkey) + 50 mg/mL MgSO4 (Magnezyum Sulfat %15, Biofarma, Istanbul, Turkey). MgSO4 diluted to 50mg/mL with normal saline (Polifleks %0.9 İzotonik Sodyum Klorür, Polifarma, Ankara, Turkey).

Group Type ACTIVE_COMPARATOR

25 mg MgSO4 (Magnezyum Sulfat %15, Biofarma, Istanbul, Turkey)

Intervention Type DRUG

It will be evaluated whether there is postpinal shivering in the cases.

Group M100

Patients receiving intrathecal 10 mg hyperbaric bupivacaine (Marcaine® Spinal Heavy %0.5, Sanofi, Kırklareli, Turkey) + 100 mg MgSO4 (Magnezyum Sulfat %15, Biofarma, Istanbul, Turkey). MgSO4 diluted to 100mg/mL with normal saline (Polifleks %0.9 İzotonik Sodyum Klorür, Polifarma, Ankara, Turkey)

Group Type ACTIVE_COMPARATOR

25 mg MgSO4 (Magnezyum Sulfat %15, Biofarma, Istanbul, Turkey)

Intervention Type DRUG

It will be evaluated whether there is postpinal shivering in the cases.

Interventions

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25 mg MgSO4 (Magnezyum Sulfat %15, Biofarma, Istanbul, Turkey)

It will be evaluated whether there is postpinal shivering in the cases.

Intervention Type DRUG

Other Intervention Names

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50 mg MgSO4 (Magnezyum Sulfat %15, Biofarma, Istanbul, Turkey) 75 mg MgSO4 (Magnezyum Sulfat %15, Biofarma, Istanbul, Turkey) 100 mg MgSO4 (Magnezyum Sulfat %15, Biofarma, Istanbul, Turkey)

Eligibility Criteria

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Inclusion Criteria

* Who were scheduled for elective C/S under SA,
* 18-40 years of age
* ASA physical status I-II.

Exclusion Criteria

* Any contraindications to SA,
* preoperative body temperature \>38 C,
* allergy to any drug used in the study,
* pre-eclampsia, and eclampsia,
* neuropathy,
* respiratory distress,
* coagulopathy, and
* any possible drugs that can change body temperature,
* ASA physical status \> II.
Minimum Eligible Age

18 Years

Maximum Eligible Age

40 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Yuzuncu Yıl University

OTHER

Sponsor Role lead

Responsible Party

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Nureddin YUZKAT

Assoc. proffesor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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NUREDDİN YUZKAT, Assoc. prof

Role: PRINCIPAL_INVESTIGATOR

VAN YUZUNCU YIL UNİVERSİTY

Locations

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Van yuzuncu Yıl University, Dursun Odabas Medical Center

Van, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Ameta N, Jacob M, Hasnain S, Ramesh G. Comparison of prophylactic use of ketamine, tramadol, and dexmedetomidine for prevention of shivering after spinal anesthesia. J Anaesthesiol Clin Pharmacol. 2018 Jul-Sep;34(3):352-356. doi: 10.4103/joacp.JOACP_211_16.

Reference Type BACKGROUND
PMID: 30386019 (View on PubMed)

Hoshijima H, Takeuchi R, Kuratani N, Nishizawa S, Denawa Y, Shiga T, Nagasaka H. Incidence of postoperative shivering comparing remifentanil with other opioids: a meta-analysis. J Clin Anesth. 2016 Aug;32:300-12. doi: 10.1016/j.jclinane.2015.08.017. Epub 2015 Oct 1.

Reference Type BACKGROUND
PMID: 26432635 (View on PubMed)

Jayaraj A, Balachander H, Kuppusamy SK, Arusamy S, Rai Y, Siddiqui N. Comparison of meperidine, tramadol and fentanyl for post-spinal shivering prevention during cesarean delivery: A double-blind randomized controlled trial. J Obstet Gynaecol Res. 2019 Nov;45(11):2202-2208. doi: 10.1111/jog.14106. Epub 2019 Sep 4.

Reference Type BACKGROUND
PMID: 31486253 (View on PubMed)

Other Identifiers

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Intrathecal magnesium sulfate

Identifier Type: -

Identifier Source: org_study_id

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