Frontiers in pharmacology · 2025
Effect of preoperative intranasal dexmedetomidine versus placebo on intraoperative shivering in parturients undergoing cesarean section: a randomized controlled trial.
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Xu Guolin, Tian Zhuhong, Ding Yong, Ma Jingjing, Li Rui
Аннотация
BACKGROUND: Shivering during cesarean section under epidural anesthesia is common and may negatively affect maternal comfort, surgical conditions, and physiological stability. This single-blinded, randomized controlled trial evaluated whether preoperative intranasal dexmedetomidine reduces the incidence of shivering in parturients undergoing cesarean delivery.
METHODS: A total of 170 parturients scheduled for elective cesarean section under continuous epidural anesthesia were randomized into a dexmedetomidine group (group DEX) or control group (group CON). The group DEX received 1 μg/kg intranasal dexmedetomidine (diluted to 1 mL), and the group CON received 1 mL intranasal normal saline approximately 30 min before anesthesia. The primary outcomes were the incidence, severity, frequency, and duration of shivering. Neonatal safety was evaluated using Apgar scores at 1 and 5 min after delivery.
RESULTS: A total of 160 patients completed the study. The incidence, frequency, severity, and duration of intraoperative shivering reactions were significantly lower in the group DEX than in the group CON (P < 0.01). Compared with those in the group CON, there were significantly more patients with level 2 sedation in the group DEX (P < 0.01). There were no significant differences in maternal hypotension, bradycardia, or nausea and vomiting events between the two groups (P > 0.01). There were no significant differences in Apgar scores between the two groups (P > 0.05).
CONCLUSION: Preoperative intranasal administration of dexmedetomidine effectively prevents intraoperative shivering in parturients undergoing cesarean section.
CLINICAL TRIAL REGISTRATION: https://www.chictr.org.cn identifier: ChiCTR2400079811.
METHODS: A total of 170 parturients scheduled for elective cesarean section under continuous epidural anesthesia were randomized into a dexmedetomidine group (group DEX) or control group (group CON). The group DEX received 1 μg/kg intranasal dexmedetomidine (diluted to 1 mL), and the group CON received 1 mL intranasal normal saline approximately 30 min before anesthesia. The primary outcomes were the incidence, severity, frequency, and duration of shivering. Neonatal safety was evaluated using Apgar scores at 1 and 5 min after delivery.
RESULTS: A total of 160 patients completed the study. The incidence, frequency, severity, and duration of intraoperative shivering reactions were significantly lower in the group DEX than in the group CON (P < 0.01). Compared with those in the group CON, there were significantly more patients with level 2 sedation in the group DEX (P < 0.01). There were no significant differences in maternal hypotension, bradycardia, or nausea and vomiting events between the two groups (P > 0.01). There were no significant differences in Apgar scores between the two groups (P > 0.05).
CONCLUSION: Preoperative intranasal administration of dexmedetomidine effectively prevents intraoperative shivering in parturients undergoing cesarean section.
CLINICAL TRIAL REGISTRATION: https://www.chictr.org.cn identifier: ChiCTR2400079811.