Effect of Dexmedetomedine in combination with intrathecal bupivacaine on the incidence of shivering after orthopedic surgery of the femur and tibia: a double-blind randomized clinical trial study

Post-anesthesia shivering causes discomfort in the patient. Many drugs have tried to prevent or reduce shivering, but the ideal drug has not been finalized yet. The purpose of this study was todetermine the effect of dexodomodinewith bupivacaine in spinal anesthesia to prevent shivering in orthopedic fracture surgeryof femur and tibia.

This randomized clinical trial study was performed on 60 patients 18-50 years old with ASA class 1 and 2 who were candidates for tibia and femur orthopedic fracture surgeryin 2018. Patients were randomly divided into two groups; Intervention group: 12.5 mg bupivacaine (2.5 cc) and 5 μgdexmedetomidine (0.5 ml) and control group: 12.5 mg bupivacaine and 0.5 ml normal. Systolic, diastolic, and mean arterial blood pressure and blood O2% saturationwere recorded before spinal anesthesia, after anesthesia and then every 15 minutes until surgery and recovery time. At 2, 4, 8, 12 and 24 hours postoperatively shivering was evaluated. Data were analyzed using descriptive statistics indices (mean, percentage and standard deviation) and inferential statistical tests (chi-square, t-test, and Mann-Whitneyu) using SPSS 21 software.

The mean age of patients in the control group was 36.6 ±14.7 years and the intervention group was 32.7± 8.6 years. There was no significant difference in the frequency of shivering between the control and intervention groups at 2(4.3% vs. 7.1%) and 4(4.5% vs. 24.1%).Although, intervention subjects had no any shivering state at hours of 8, 12 and 24, but there was no significantly different compared to control group (7.1%, 3.6% and 3.6%, respectively).
 

The results of study showed that addition of 5 μgdexmedetomidine to bupivacaine in spinal anesthesia reduces the incidence of postoperative shivering, but this difference was not statistically significant. Thus, in this subject seems bee need to studies with whole and large sample of participants.