Antishivering Effect of Dexmedetomidine on Patients Undergoing Video-Assisted Thoracoscopic Wedge Resection

Post-anesthetic shivering can cause post surgical pain or discomfort, and create oxygen supply/demand imbalance.
The current study aimed at evaluating the effects of Dexmedetomidine on the incidence and intensity of shivering and core temperature after general anesthesia.
The current randomized, double-blind, placebo-controlled, clinical trial was conducted at a single center (Gil Medical Center, Incheon, South Korea) from January to December 2016 with convenience sampling and simple random allocation. A total of 40 patients undergoing video-assisted thoracoscopic (VATS) wedge resection were randomly assigned to receive either 1 µg/kg of Dexmedetomidine (Dexmedetomidine group, n = 20) or normal saline (control group, n = 20) 10 minutes after skin incision. Hemodynamic variables and esophageal and tympanic temperatures were recorded five minutes after anesthetic induction, five minutes after achieving a lateral position, every five minutes after carbon dioxide insufflation to the thoracic cavity, and at the end of surgery. Incidences and intensities of post-anesthetic shivering, and postoperative pain scores were recorded.
Median postoperative pain score was significantly lower in the Dexmedetomidine group than the control group (4 (0 - 5) vs. 5 (3.25 - 6) (median (interquartile range)), P = 0.004). In the post-anesthetic care unit (PACU), the incidence of shivering was significantly lower in the Dexmedetomidine group than in the control group (0/20 (0%) vs. 6/20 (30%), P = 0.020); but the incidence of hypothermia was higher in the Dexmedetomidine group than in the control group (6/20 (30%) vs. 0/20 (0%), P = 0.020).
A single intraoperative dose of Dexmedetomidine (1 µg/kg) may reduce postoperative shivering and pain scores, but it might also increase the incidence of postoperative hypothermia in patients undergoing Sevoflurane anesthesia for videoassisted thoracoscopic wedge resection.