Comparison of intravenous Dexmedetomidine and Meperidine in the treatment of post spinal shivering in cesarean section

Determination of the effect of intravenous Dexmedetomidine and Meperidine in the treatment of post spinal shivering in cesarean section.

This randomized, double-blind clinical trial with parallel groups and phase 2-3 will be conducted on 246 pregnant patients aged 18 to 46 who are candidates for caesarean section under spinal anesthesia who experience shivering after anesthesia, and block randomization is used for randomization.

After spinal anesthesia and ensuring sensory block at the T4 level, all patients will be prepped and covered with a double layer of surgical drapes and the surgery will begin. During surgery and recovery, patients will be checked for shivering. In case of shivering in group A , patients will receive meperidine 0.5mg/kg and in group B , patients will receive dexmedetomidine 0.5ug/kg after umbilical cord clamping with a total volume of 20ml within 10 minutes.Then the intensity of shivering, blood pressure, heart rate, spo2, and sedation score will be measured at intervals of 5, 10, 15, 20, and 30 minutes after the administration of the drugs. Nausea, vomiting, and dizziness will also be checked.

Inclusion criteria:Withdrawal from participation of the study; 18 to 46 years old; Parturient patients with post spinal shivering. Exclusion criteria: Withdrawal from participation of the study; Cardiac and pulmonary diseases,; Eclampsia and preeclampsia; Contraindications of spinal anesthesia; History of seizures or Parkinson; Intraoperative transfusion; Taking sedative and vasodilator drugs; Dysautonomia; Allergy to the drugs.

After spinal anesthesia and the start of surgery, if there is shivering , the patients are randomly assigned to one of the two groups of meperidine and dexmedomidine .

Intensity of [post spinal shivering.

In this study, we will use the quadruple Block Randomization method. For this purpose, we prepare four sheets of paper.Write the letter A on two sheets and the letter B on the other two sheets. Mix the sheets together and place them in the desk drawer. With the referral of each eligible patient, one of the sheets is randomly taken out and based on this sheet is A or B, it will be assigned to one of the two groups of Dexmedetomidine and Meperidine. After randomly pulling out all four sheets, all the papers are returned to the drawer and the above procedure will be continued for the next four patients until the desired sample size is reached.

After spinal anesthesia and the start of surgery and delivery of the baby, if the patient experiences shivering, she will receive one of the drugs Dexmedomidine and Meperidine,which is prepared in syringes with the same size and shape and labeled A and B by the nurse of anesthesia who is not involved in collecting or recording data.