Kundra Tanveer Singh, Kaur Parminder
Department of Anesthesia, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India.
Department of Critical Care, Sir Ganga Ram Hospital, New Delhi, India.
J Anaesthesiol Clin Pharmacol. 2017 Oct-Dec;33(4):493-495. doi: 10.4103/joacp.JOACP_115_16.
Shivering is a common postanesthesia adverse event with multiple etiologies. Dexmedetomidine, a centrally acting alpha-2 adrenergic agonist, is known to reduce the shivering threshold. However, the minimum dose at which dexmedetomidine causes cessation of shivering is unknown. The aim of this prospective observational study was to find the minimum dosage of dexmedetomidine required for abolition of post-spinal anesthesia (SA) shivering.
Thirty patients having shivering after SA were enrolled, who received dexmedetomidine in the dosage of 1 mcg/kg over 10 min. The time-to-cessation of shivering and the dose of dexmedetomidine required were expressed as mean ± standard deviation.
The mean time-to-cessation of shivering after starting dexmedetomidine infusion was 155.88 ± 15.16 s for Grade 3 shivering and 177.71 ± 10.87 s for Grade 4 shivering. Till that time, the mean dose of dexmedetomidine which had been infused was 0.258 ± 0.024 mcg/kg in Grade 3 shivering and 0.295 ± 0.018 mcg/kg in Grade 4 shivering.
The minimum dose of dexmedetomidine required for abolition of shivering was 0.258 ± 0.024 mcg/kg for patients with Grade 3 shivering and 0.295 ± 0.018 mcg/kg for patients with Grade 4 shivering, which is much less than the commonly administered dose.
寒战是一种常见的麻醉后不良事件,病因多样。右美托咪定是一种中枢作用的α-2肾上腺素能激动剂,已知可降低寒战阈值。然而,右美托咪定导致寒战停止的最小剂量尚不清楚。这项前瞻性观察研究的目的是找出消除脊麻后(SA)寒战所需的右美托咪定的最小剂量。
纳入30例脊麻后出现寒战的患者,他们在10分钟内接受了1 mcg/kg剂量的右美托咪定。寒战停止时间和所需的右美托咪定剂量以平均值±标准差表示。
开始输注右美托咪定后,3级寒战患者寒战停止的平均时间为155.88±15.16秒,4级寒战患者为177.71±10.87秒。在此之前,3级寒战患者输注的右美托咪定平均剂量为0.258±0.024 mcg/kg,4级寒战患者为0.295±0.018 mcg/kg。
消除寒战所需的右美托咪定最小剂量,3级寒战患者为0.258±0.024 mcg/kg,4级寒战患者为0.295±0.018 mcg/kg,远低于常用剂量。