Nalbuphine versus dexmedetomidine for treatment of combined spinal-epidural post-anesthetic shivering in pregnant women undergoing cesarean section

• Published in: Journal of international medical research 2019-09, Vol.47 (9), p.4442-4453
• Main Authors: Sun, Jing, Zheng, Zhao, Li, Yi-Lu, Zou, Li-Wei, Li, Ge-Hui, Wang, Xiao-Guang, She, Bao-Zuan, Huang, Xiao-Lei, Li, Yuan-Tao
• Format: Article
• Language: English
• Subjects: Adult; Anesthesia; Anesthesia, Epidural - adverse effects; Anesthesia, Spinal - adverse effects; Blood Glucose - metabolism; Cesarean section; Cesarean Section - adverse effects; Clinical Research Reports; Dexmedetomidine - pharmacology; Dexmedetomidine - therapeutic use; Female; Health risk assessment; Humans; Insulin - blood; Nalbuphine - pharmacology; Nalbuphine - therapeutic use; Postoperative Complications - etiology; Pregnancy; Shivering - drug effects; Time Factors; Treatment Outcome; Uterine Contraction - drug effects; Visual Analog Scale
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/0300060519865063

Objective This study aimed to compare the clinical efficacy and side effects of nalbuphine and dexmedetomidine for treatment of combined spinal-epidural anesthetic shivering in women after cesarean section. Methods A total of 120 pregnant women, who underwent elective cesarean section under combined spinal-epidural anesthesia, were enrolled in a double-blind, randomized study. These women were randomized into three groups of 40 pregnant women each to receive either saline (group C), nalbuphine 0.07 mg/kg (group N), or dexmedetomidine 0.5 µg/kg (group D) for treatment of shivering after anesthesia. The main outcome measure was a significant reduction in the time required for shivering after intervention. Results The mean time to cessation of shivering in groups N and D was significantly shorter than that in group C (3.5±2.7 and 4.2±3.7 versus 14.5±1.4 minutes). The success rate of shivering treatment and Observer’s Assessment of Alertness/Sedation scores in groups N and D were significantly higher than those in group C, while the recurrence rate was lower than that in group C. Conclusion Nalbuphine 0.07 mg/kg can be used safely and effectively for shivering in pregnant women under combined spinal-epidural anesthesia.