Role of Intravenous Dexmedetomidine in Reducing Shivering After Shivering Cesarean Section Due to Spinal Anesthesia

NCT ID: NCT06711913

Last Updated: 2024-12-02

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

PHASE2

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-12-21

Study Completion Date

2024-06-21

Brief Summary

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"After spinal anesthesia, some patients may experience shivering, which can be uncomfortable and even lead to complications. Dexmedetomidine is a medication that can help prevent or reduce this shivering.

Dexmedetomidine helps to:

1. Reduces shivering and discomfort.
2. Improves patient comfort and satisfaction.
3. Regulates body temperature.
4. Safe and effective.

Detailed Description

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Post-spinal shivering is a common complication that occurs in 40-65% of patients undergoing spinal anesthesia. It is characterized by involuntary, rhythmic muscle contractions that can lead to discomfort, anxiety, and increased oxygen consumption.

The exact mechanisms underlying post-spinal shivering are not fully understood, but several factors contribute to its development:

1. \*Hypothermia\*: Spinal anesthesia can cause a decrease in core body temperature, leading to shivering.
2. \*Sympathetic blockade\*: Spinal anesthesia blocks sympathetic nerve fibers, causing vasodilation and decreased blood flow to the extremities.
3. \*Increased oxygen consumption\*: Shivering increases oxygen consumption, which can be detrimental in patients with pre-existing cardiovascular or respiratory disease.

\*Effects of Dexmedetomidine on Post-Spinal Shivering\*

Dexmedetomidine, an alpha-2 adrenergic agonist, has been shown to effectively reduce post-spinal shivering. Its effects include:

1. \*Decreased shivering intensity\*: Dexmedetomidine reduces the severity of shivering, making patients more comfortable.
2. \*Increased core body temperature\*: Dexmedetomidine helps to maintain core body temperature, reducing the likelihood of hypothermia-induced shivering.
3. \*Reduced oxygen consumption\*: By decreasing shivering, dexmedetomidine reduces oxygen consumption, which is beneficial for patients with cardiovascular or respiratory disease.
4. \*Improved patient comfort\*: Dexmedetomidine's sedative and anxiolytic effects contribute to improved patient comfort and satisfaction.
5. \*Reduced need for other anti-shivering interventions\*: Dexmedetomidine's effectiveness in reducing post-spinal shivering may reduce the need for other interventions, such as meperidine, clonidine, or forced-air warming.

Dexmedetomidine's anti-shivering effects are thought to be mediated by its actions on the following mechanisms:

1. \*Alpha-2 adrenergic receptors\*: Dexmedetomidine activates alpha-2 adrenergic receptors, which decreases sympathetic outflow and reduces shivering.
2. \*Hypothalamic thermoregulation\*: Dexmedetomidine may affect the hypothalamus, the body's thermoregulatory center, to reduce shivering and maintain core body temperature.
3. \*Spinal cord mechanisms\*: Dexmedetomidine may also act on the spinal cord to reduce shivering, possibly by inhibiting the release of excitatory neurotransmitters.

Conditions

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Shivering

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Intervention group

Received intravenous dexmedetomidine

Group Type ACTIVE_COMPARATOR

Dexmedetomidine

Intervention Type DRUG

intravenous dexmedetomidine given in form of 100ml infusion over 10 minutes

Control group

control group receive normal saline

Group Type PLACEBO_COMPARATOR

Normal Saline (Placebo)

Intervention Type OTHER

control group receive normal saline as placebo

Interventions

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Dexmedetomidine

intravenous dexmedetomidine given in form of 100ml infusion over 10 minutes

Intervention Type DRUG

Normal Saline (Placebo)

control group receive normal saline as placebo

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Elective Cesarean section
* Age limit 18 to 35 years
* ASA II

Exclusion Criteria

* Emergency cesarean delivery
* hypersensitive to dexmedetomidine
* Pateint with hear, renal, or hepatic diseases requiring follow up
* Pre-eclemptic pateint
* Patient with GA
* Combined spinal epidural anesthesia
Minimum Eligible Age

18 Years

Maximum Eligible Age

35 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Liaquat National Hospital & Medical College

OTHER

Sponsor Role lead

Responsible Party

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Ghulam Fatima

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ghulam Fatima kharl

Role: PRINCIPAL_INVESTIGATOR

Liaquat national hospital and medical college

Locations

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Liaquat National Hospital and Medical College

Karachi, Sindh, Pakistan

Site Status

Countries

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Pakistan

Related Links

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https://doi.org/10.7759/cureus.32425

Kumar S, Choudhury B, Varikasuvu SR, Singh H, Kumar S, Lahon J, et al. A Systematic Review and Meta-analysis of Efficacy and Safety of Dexmedetomidine Combined With Intrathecal Bupivacaine Compared to Placebo. Cureus. 2022;14(12):e32425.

Other Identifiers

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Dr ghulam fatima

Identifier Type: OTHER

Identifier Source: secondary_id

Liaquat National Hospital 1234

Identifier Type: -

Identifier Source: org_study_id