Evaluation of the Efficacy of Dexamethasone Versus Magnesium Sulfate in Prevention of Postspinal Shivering: A Prospective, Randomized, Double-Blind Study
Journal of Cellular & Molecular Anesthesia,
Vol. 8 No. 2 (2023),
26 February 2023
Background: Postspinal shivering represents one of the distressing complications of regional anesthesia. This study evaluated the efficacy of dexamethasone and magnesium sulfate to prevent postspinal shivering (PSAS) in lower abdominal and lower limb surgeries.
Materials and Methods: Hundred forty-seven patients undergoing elective abdominal and lower limb surgery under spinal anesthesia received either 100 mL isotonic saline (group C), 8 mg in 100 mL isotonic saline (group D), or magnesium sulfate 30 mg/kg in 100 mL isotonic saline (Group M).
Results: The incidence of clinically significant shivering was highly significantly less in group D and group M compared to group C (p=0.001), however, there was no statistically significant difference between group D and group M (p=0.052). The onset of shivering was significantly lower in the C group compared to the D and M groups with statistically significant differences between the D and M groups (p=0.001).
Conclusion: Dexamethasone and magnesium sulfate were effective in the prevention of PSAS in patients undergoing lower abdominal and lower limb surgeries under spinal anesthesia. However, magnesium sulfate is better than dexamethasone as it is accompanied by less incidence of shivering, and its sedative effect decreases the stress of the surgery.
- postspinal shivering, spinal anesthesia, dexamethasone, magnesium sulfate
How to Cite
Sachidananda R, Basavaraj K, Shaikh SI, Umesh G, Bhat T, Arpitha B. Comparison of Prophylactic Intravenous Magnesium Sulfate with Tramadol for Postspinal Shivering in Elective Cesarean Section: A Placebo Controlled Randomized Double-blind Pilot Study. Anesth Essays Res. 2018;12(1):130-4.
Badjatia N, Strongilis E, Gordon E, Prescutti M, Fernandez L, Fernandez A, et al. Metabolic impact of shivering during therapeutic temperature modulation: the Bedside Shivering Assessment Scale. Stroke. 2008;39(12):3242-7.
Mohamed SA, Sayed DM, El Sherif FA, Abd El-Rahman AM. Effect of local wound infiltration with ketamine versus dexmedetomidine on postoperative pain and stress after abdominal hysterectomy, a randomized trial. Eur J Pain. 2018;22(5):951-60.
Esmat IM, Mohamed MM, Abdelaal WA, El-Hariri HM, Ashoor TM. Postspinal anesthesia shivering in lower abdominal and lower limb surgeries: a randomized controlled comparison between paracetamol and dexamethasone. BMC Anesthesiol. 2021;21(1):262.
Amsalu H, Zemedkun A, Regasa T, Adamu Y. Evidence-Based Guideline on Prevention and Management of Shivering After Spinal Anesthesia in Resource-Limited Settings: Review Article. Int J Gen Med. 2022;15:6985-98.
Mohamed SA, El Mekawy NMA, R.M., Elsonbaty AIA, Elsonbaty MIA. Magnesium sulfate intravenous infusion versus intrathecal injection for prevention of post-spinal shivering during lower limb fracture surgery: a randomized controlled study. Ain-Shams J Anesthesiol. 2021;13(1):27.
Entezariasl M, Isazadehfar K. Dexamethasone for prevention of postoperative shivering: a randomized double-blind comparison with pethidine. Int J Prev Med. 2013;4(7):818-24.
Kawakami H, Nakajima D, Mihara T, Sato H, Goto T. Effectiveness of Magnesium in Preventing Shivering in Surgical Patients: A Systematic Review and Meta-analysis. Anesth Analg. 2019;129(3):689-700.
Memiş D, Turan A, Karamanlioglu B, Oguzhan N, Pamukçu Z. Comparison of sufentanil with sufentanil plus magnesium sulphate for sedation in the intensive care unit using bispectral index. Crit Care. 2003;7(5):R123-8.
Mirkheshti A, Aryani MR, Shojaei P, Dabbagh A. The Effect of Adding Magnesium Sulfate to Lidocaine Compared with Paracetamol in Prevention of Acute Pain in Hand Surgery Patients Under Intravenous Regional Anesthesia (IVRA). Int J Prev Med. 2012;3(9):616-21.
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