Dexmedetomidine and meperidine additively reduce the shivering threshold in humans

Hypothermia might prove to be therapeutically beneficial in stroke victims; however, even mild hypothermia provokes vigorous shivering. Meperidine and dexmedetomidine each linearly reduce the shivering threshold (triggering core temperature) with minimal sedation. We tested the hypothesis that meper...

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Bibliographic Details
Published in:Stroke (1970) 2003-05, Vol.34 (5), p.1218-1223
Main Authors: DOUFAS, Anthony G, LIN, Chun-Ming, SULEMAN, Mohammad-Irfan, LIEM, Edwin B, LENHARDT, Rainer, MORIOKA, Nobutada, AKCA, Ozan, SHAH, Yunus M, BJORKSTEN, Andrew R, SESSLER, Daniel I
Format: Article
Language:English
Subjects:
Adolescent
Adrenergic alpha-Agonists - adverse effects
Adrenergic alpha-Agonists - blood
Adrenergic alpha-Agonists - pharmacology
Adult
Biological and medical sciences
Body Temperature - drug effects
Carbon Dioxide - blood
Depression, Chemical
Dexmedetomidine - adverse effects
Dexmedetomidine - blood
Dexmedetomidine - pharmacology
Drug Synergism
Hemodynamics - drug effects
Humans
Hypothermia, Induced
Male
Medical sciences
Meperidine - adverse effects
Meperidine - blood
Meperidine - pharmacology
Neuropharmacology
Neuroprotective agent
Oxygen Consumption - drug effects
Partial Pressure
Pharmacology. Drug treatments
Receptors, Opioid, mu - agonists
Respiration - drug effects
Shivering - drug effects
Skin Temperature
Tympanic Membrane
Vasoconstriction - drug effects
Wakefulness - drug effects
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Summary:Hypothermia might prove to be therapeutically beneficial in stroke victims; however, even mild hypothermia provokes vigorous shivering. Meperidine and dexmedetomidine each linearly reduce the shivering threshold (triggering core temperature) with minimal sedation. We tested the hypothesis that meperidine and dexmedetomidine synergistically reduce the shivering threshold without producing substantial sedation or respiratory depression. We studied 10 healthy male volunteers (18 to 40 years) on 4 days: (1) control (no drug); (2) meperidine (target plasma level 0.3 microg/mL); (3) dexmedetomidine (target plasma level 0.4 ng/mL); and (4) meperidine plus dexmedetomidine (target plasma levels of 0.3 microg/mL and 0.4 ng/mL, respectively). Lactated Ringer's solution (approximately 4 degrees C) was infused through a central venous catheter to decrease tympanic membrane temperature by approximately 2.5 degrees C/h; mean skin temperature was maintained at 31 degrees C. An increase in oxygen consumption >25% of baseline identified the shivering threshold. Sedation was evaluated by using the Observer's Assessment of Sedation/Alertness scale. Two-way repeated-measures ANOVA was used to identify interactions between drugs. Data are presented as mean+/-SD; P
ISSN:0039-2499
1524-4628
DOI:10.1161/01.str.0000068787.76670.a4