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Optimal dose of prophylactic dexmedetomidine for preventing postoperative shivering

Title
Optimal dose of prophylactic dexmedetomidine for preventing postoperative shivering
Authors
Kim Y.-S.Kim Y.-I.Seo K.-H.Kang H.-R.
Ewha Authors
김용일
SCOPUS Author ID
김용일scopus
Issue Date
2013
Journal Title
International Journal of Medical Sciences
ISSN
1449-1907JCR Link
Citation
vol. 10, no. 10, pp. 1327 - 1332
Indexed
SCIE; SCOPUS WOS scopus
Abstract
Objective The aim of this study was to investigate the optimum dosage of dexmedetomidine for prevention of postanesthetic shivering. Methods One-hundred thirty two ASA physical status I-II patients scheduled for elective laparoscopic total hysterectomy were enrolled in this randomised, placebo-controlled study. Patients were randomly allocated to receive dexmedetomidine in four groups: group S (0.9% normal saline), group D0.5 (dexmedetomidine 0.5 μg/kg), group D0.75 (dexmedetomidine 0.75 μg/kg), group D1.0 (dexmedetomidine 1.0 μg/kg). Time to extubation and tympanic temperature during and after operation were measured. Shivering was graded (0-3 scale) upon patients arrival to the PACU and every ten minutes thereafter up to forty minutes. Sedation and first rescue analgesic time at the PACU were evaluated. Results The incidence of shivering was significantly lower in group D0.75 and D1.0 than in group S (P< 0.05). There were significantly fewer patients with a shivering score of 2 or 3 in groups D0.75 and D1.0 than in group S (P< 0.05, P < 0.001). Extubation time was shorter in group S than in groups D0.75 and D1.0 (P< 0.05). Tympanic temperature at 40 minutes postoperatively in the recovery room was higher in group S than in the other dexmedetomidine groups (P< 0.05) Fewer patients required rescue analgesia in groups D0.75 and D1.0 than in group S (P< 0.001), and the time to rescue analgesia was longer in group D1.0 than in group S (P< 0.001). Modified Observer's Assessment of Alertness/Sedation (MOAA/S) at arrival in the PACU was lower in all dexmedetomidine groups than in group S (P< 0.05). Conclusions Our results suggest that dexmedetomidine 0.75 or 1.0 μg/kg provides effective prophylaxis against postoperative shivering as well as an analgesic effect. Though potential for intraoperative requirement for atropine, sedation in the immediate recovery period and delayed extubation time with dexmedetomidine was noted, there were no major clinical impacts on the overall recovery from anesthesia. © Ivyspring International Publisher.
DOI
10.7150/ijms.6531
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의과대학 > 의학과 > Journal papers
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