scholarly journals The Preventive Effects of two Different Doses of Dexmedetomidine on Shivering in Cesarean Section under Spinal Anesthesia

2021 ◽  
Vol 15 (7) ◽  
pp. 2352-2357
Author(s):  
Behzad Nazemroaya ◽  
Samira Heydari
Keyword(s):  
Side Effects ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Spinal Anesthesia ◽  
Normal Saline ◽  
Target Population ◽  
Control Group ◽  
Medical Sciences ◽  
Double Blind ◽  
Different Doses

Introduction: One of the side effects caused by spinal anesthesia is seizures of impaired body temperature regulation, which in addition to causing concern for the mother, can lead to problems such as cardiovascular and respiratory disorders. This has led to the choice of the appropriate drug to reduce shivering, with the least neonatal and maternal side effects in cesarean section. The main purpose of this study was to compare the prophylactic effect of intravenous dexmedetomidine at two different doses for cesarean section induced shivering under spinal anesthesia. Methods: This article is a double blind randomized clinical trial study performed in Isfahan University of Medical Sciences (Alzahra and Shahid Beheshti). The target population of the study was pregnant women with indication of cesarean section. In this study 60 pregnant women were divided into three groups. In the first group patients were injected with 2.5 mg / kg dexmedetomidine, in the second group patients with 5 mg / kg dexmedetomidine and in the third group with similar volume, normal saline was injected and the shivering intensity in patients with the use of Grassi and Mahajan criteria was evaluated. Finally, the collected data were analyzed using SPSS software and Kruskal-Wallis One-Way ANOVA tests. Results: According to the statistical analysis of the data, after cesarean section with spinal anesthesia, shivering intensity in the 5mg / kg dexmedetomidine group was lower than in the 2.5mg group and less than the control group. Normal saline was given as prophylaxis. Conclusion: Intravenous dexmedetomidine, especially at a dose of 5 μg / kg, has a significant effect on reducing postoperative shivering by cesarean section with spinal anesthesia. Keywords: Dexmedetomidine, Shivering, Cesarean section, Spinal anesthesia

scholarly journals Perbandingan Efektivitas Anestesi Spinal dengan Bupivacain 12,5 Mg dan Bupivacain 5 Mg yang ditambah Fentanyl 50 Mcg pada Seksio Sesarea

2021 ◽  
Vol 4 (1) ◽  
pp. 11-7
Author(s):  
Fritzky Indradata ◽  
Heri Dwi Purnomo ◽  
Muh. Husni Thamrin ◽  
Sugeng Budi Santoso ◽  
Ardana Tri Arianto ◽  
...  
Keyword(s):  
Side Effects ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Randomized Control Trial ◽  
Hyperbaric Bupivacaine ◽  
Chi Square ◽  
Double Blind ◽  
Duration Of Action ◽  
Significant Difference ◽  
Randomized Control

Latar Belakang: Anestesi spinal mempunyai efek samping berupa hipotensi dan mual muntah. Tujuan: penelitian ini adalah membandingkan efek anestesi spinal bupivacain dosis normal 12,5 mg dan bupivacain dosis rendah 5 mg dengan fentanyl 50 mg pada seksio sesarea terhadap perubahan hemodinamik, ketinggian blok, onset, durasi dan efek samping. Subjek dan Metode: Penelitian double blind randomized control trial pada 36 pasien yang memenuhi kriteria. Pasien dibagi menjadi dua kelompok, yang masing-masing terdiri 18 pasien, kelompok 1 dilakukan anestesi spinal dengan bupivacain hiperbarik 5 mg ditambah adjuvan fentanyl 50 mcg, sedangkan kelompok 2 diberikan bupivacain hiperbarik 12,5 mg. Penilaian meliputi saat mula kerja blokade sensorik, mula kerja blokade motorik, durasi, tekanan darah, laju nadi, dan saturasi oksigen, lama kerja dan efek samping. Data hasil penelitian diuji secara statistik dengan uji chi-square. Hasil: Terdapat perbedaan signifikan pada onset dan durasi blokade sensorik dan motorik, bupivacain 12,5 mg lebih baik dibandingkan bupivacain 5 mg + fentanyl 50 mcg (p<0.05). Tidak ada perbedaan signifikan pada perubahan tanda vital dan efek samping (p>0.05). Simpulan: Bupivacain 12,5 mg menghasilkan onset lebih cepat dan durasi lebih lama dibandingkan bupivacain 5 mg + fentanil 50 mcg pada anestesi spinal untuk seksio sesarea   Comparison of The Effectiveness Spinal Anesthesia with Bupivacaine 12,5 Mg and Bupivacaine 5 Mg added Fentanyl 50 Mcg in Caesarean Section Abstract Background: Spinal anesthesia has side effects such as hypotension and nausea and vomiting. Objective: The aim of this study was to compare the effects of spinal anesthesia with normal doses of 12,5 mg of bupivacaine and 5 mg of low-dose bupivacaine with fentanyl 50 mg in the cesarean section on hemodynamic changes, block height, onset, duration, and side effects. Subjects and Methods: Double-blind randomized control trial in 36 patients who met the criteria. Patients were divided into two groups, each consisting of 18 patients, group 1 underwent spinal anesthesia with 5 mg of hyperbaric bupivacaine plus 50 mcg of fentanyl adjuvant, while group 2 was given 12,5 mg of hyperbaric bupivacaine. Assessments include the initiation of sensory block action, onset of motor block action, duration, blood pressure, pulse rate, and oxygen saturation, duration of action, and side effects. The research data were statistically tested with the chi-square test. Results: There were significant differences in the onset and duration of sensory and motor blockade, bupivacaine 12,5 mg was better than bupivacaine 5 mg + fentanyl 50 mcg (p <0.05). There was no significant difference in changes in vital signs and side effects (p> 0.05). Conclusion: Bupivacaine 12,5 mg resulted in a faster onset and longer duration than bupivacaine 5 mg + fentanyl 50 mcg in spinal anesthesia for cesarean section.

scholarly journals The Prophylactic Administration of Intravenous Paracetamol for Control of Shivering During and After Cesarean Section Under Spinal Anesthesia

2019 ◽  
Author(s):  
Sousan Rasoli ◽  
Elnaz Ansari ◽  
Farnaz Moslemi ◽  
Morteza Ghojazadeh
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Operating Room ◽  
Recovery Room ◽  
Control Group ◽  
Double Blind ◽  
Prophylactic Administration ◽  
Intravenous Paracetamol ◽  
Rate Of Increase ◽  
The Mean

Background: Shivering refers to a series of repetitive involuntary movements of the skeletal muscles commonly occurring during spinal anesthesia. Regional anesthesia (both spinal and Epidural) reduces vasoconstriction and shivering threshold to 6 degrees Celsius above the surface of the block. The aim of this study was to determine the effect of prophylactic administration of intravenous paracetamol in controlling shivering during and after cesarean section under spinal anesthesia. Methods: In a double-blind randomized clinical trial in the Department of Anesthesiology of Tabriz on patients undergoing cesarean section with spinal anesthesia, the effect of prophylactic administration of paracetamol IV in controlling shivering during and after cesarean section under spinal anesthesia was evaluated. Results: The mean gestational age of patients was 37.94±1.07 weeks in paracetamol group and 37.58±2.07 weeks in the control group (p=0.278). The mean shivering scores of patients in paracetamol group were 0.72±0.80 in the operating room and 1.32±1.05 in recovery room (P<0.001). The mean shivering scores of patients in control group were 1.16±1.07 in the operating room and 2.28±1.45 in recovery room (P<0.001). The mean increase of shivering score in patients was 0.60±0.98 in paracetamol group and 1.12±1.46 in the control group. The mean increase of shivering score in patients in paracetamol group was significantly less than the control group (p=0.041). Conclusion: In the present study, the prophylactic use of intravenous acetaminophen reduced the rate of increase of shivering in patients after spinal anesthesia. Postoperative complications in patients in paracetamol group was less than the control group, however, this difference was not statistically significant.

Effect of intrathecal Dexmedetomidine on preventing shivering after spinal anesthesia in caesarian section

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mostafa Mohammed Mohyeldin Abdelhamid ◽  
Azza Atef AbdelAleem ◽  
Rania Maher Hussien ◽  
Ahmed Abdelghany Khalifa
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Normal Saline ◽  
Caesarian Section ◽  
University Hospitals ◽  
Double Blind ◽  
The Common

Abstract Background Shivering is among the common troublesome complications of spinal anesthesia (SA), and causes discomfort and discontentment in parturients undergoing cesarean section (CS). Objective to investigate the effects of intrathecal dexmedetomidine (DEX) as an adjuvant to heavy bupivacaine in the prevention of shivering in those who underwent CS under SA. Methods A prospective double-blind conducted at Ain Shams University hospitals on 100 parturients who are undergoing CS under Spinal anesthesia over a period of six months starting from December 2018 to May 2019 at Ain shams university hospitals. Patients were randomly subdivided into 2 groups of 50 patients each, Group BD: 5 micrograms DEX was added to 12.5 mg 0.5% heavy bupivacaine. Group BN: 0.5 mL 0.9% normal saline was added to the 12.5mg 0.5% of heavy bupivacaine. Results The incidence of shivering was significantly higher in the BN group (56%) than the BD group (24%). Likewise, the intensity of shivering was significantly higher in the BN group than the BD group. Conclusion Intrathecal DEX in conjugation with heavy bupivacaine reduced the incidence and intensity of shivering in patients undergoing cesarean section after spinal anesthesia and did not increase the incidence of hypotension or bradycardia.

scholarly journals Effect of vitamin C on the incidence and severity of postdural puncture headache in patients undergoing cesarean section with spinal anesthesia

2021 ◽  
Vol 43 (1) ◽  
pp. 55-60
Author(s):  
Sepehr Eslami ◽  
Mina Shakeri
Keyword(s):  
Vitamin C ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Normal Saline ◽  
Intervention Group ◽  
Control Group ◽  
Significant Difference ◽  
Group 2 ◽  
Positive Effect ◽  
Group 1

Background: Some studies have shown that vitamin C has a positive effect on reducing headaches after spinal anesthesia, but studies in this field are inadequate. The aim of this study was to determine the effect of vitamin C infusion on the decrease of headache after spinal anesthesia in cesarean section. Methods: This clinical trial study was performed on 160 patients undergoing cesarean section referred to Kowsar Hospital of Yazd in 2017. The patients were randomly divided into two groups including group 1, 2 gr of vitamin C in 500 cc normal saline, and group 2, 500 cc of normal saline was injected preoperatively. The two groups were compared for headache incidence. Results: At the time of recovery, 2 hours later, the frequency of headache in the intervention group was significantly lower than the control group (P <0.05). But there was no significant difference between the two groups regarding headache at 4, 6, 12, 24, and 48 hours postoperatively (P>0.05). Conclusion: Considering the patient's condition, and according to the anesthesiologist and surgeon, vitamin C can be used to reduce pain in patients undergoing cesarean section with spinal anesthesia.

scholarly journals Comparison of the Prophylactic Effect of Propofol, Dexamethasone and Ondansetron on Post-Operative Nausea and Vomiting in Elective Cesarean Section Under Spinal Anesthesia

2021 ◽  
Author(s):  
Ebrahim Hassani ◽  
Nazli Karami ◽  
Asma Hassani ◽  
Leila Hassani ◽  
Veghar Ashraf
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Elective Cesarean Section ◽  
Control Group ◽  
Double Blind ◽  
Short Period ◽  
Post Operative Nausea ◽  
Group D

Nausea, and vomiting are common complications in women undergoing cesarean section with spinal anesthesia. This study aimed to compare the propofol, dexamethasone, and ondansetron effects on nausea and vomiting. In this double-blind, randomized clinical trial study, 120 women aged 15 to 35 years candidates for cesarean section under spinal anesthesia were enrolled. Patients were randomly divided into four groups (three-drug groups and control group). Patients received 0.05 mg/kg ondansetron (group O), 0.1 mg/kg dexamethasone (group D), 0.2 mg/kg propofol (group P) and normal saline in controls (group C). Nausea and vomiting in recovery and 6 hours after surgery compared between groups. In recovery and 6 hours after surgery, both nausea and vomiting were the highest in group C while they were lowest in group O. the frequency of nausea was 11(36.7%) in both recovery and 6 hours after surgery, and the frequency of vomiting was 12(40%) and 10(33.3%) in the recovery and 6 hours after surgery respectively. Among three drug groups, nausea and vomiting were higher in group D in both the recovery room and 6 hours after surgery. The frequency of vomiting was 10 (33.3%) and 5 (16.7%) in recovery and 6 hours after surgery in group D, respectively. These differences were statistically significant between the four groups (P<0.05). The preventive effect of dexamethasone is not very useful in both periods. Therefore, it can be recommended that in the short period after surgery, propofol has a beneficial effect in preventing postoperative nausea and vomiting.

scholarly journals Effect of Maternal Pethidine on Breast Feeding Behavior of Infants in Cesarean Section by Spinal Anesthesia: A Randomized Controlled Trial

2021 ◽  
Vol 24 (8) ◽  
pp. 591-598
Author(s):  
Majid Dejbakht ◽  
Zohreh Montaseri ◽  
Jalal Saem ◽  
Mehrdad Rezaei ◽  
Marzieh Akbarzadeh
Keyword(s):  
Cesarean Section ◽  
Feeding Behavior ◽  
Spinal Anesthesia ◽  
Breast Feeding ◽  
Controlled Trial ◽  
Rapid Assessment ◽  
Test Group ◽  
Control Group ◽  
Double Blind ◽  
Significant Difference

Background: Pain control methods after cesarean section may interfere with infant breast-feeding. The aim of this study was to evaluate the effect of pethidine on breast feeding of infants born via cesarean section with spinal anesthesia. Methods: In this randomized double-blind clinical trial, we evaluated 116 infants born via cesarean section in Gerash Amiralmomenin hospital (Southern Iran) in 2017. The subjects were selected through purposive sampling and randomly by permuted block randomization and assigned to intervention and control groups. The test group received 100 mg of pethidine as intravenous infusion and the control group received only routine cares. Infants’ breast feeding behavior in both groups was recorded within 48 hours of hospitalization, using the standard tool for rapid assessment of infant feeding behavior, which consists of 4 main components of breastfeeding, including readiness to feed, rooting, latching, and sucking with a score range of 0 to 3 for each component evaluated at 1, 6, 12, 24, 36, and 48 hours postnatally. Data were analyzed using independent t tests and chi-square test. Results: The highest score of breast-feeding behavior pertained to sucking reflexes in the control group and the lowest score to breast feeding readiness in the pethidine group. Readiness for feeding in the control group (2.09±0.53) was significantly higher than the pethidine group (1.81±0.61) (95% CI: 0.0552, 0.5092 and P=0.015). Sucking reflex (95% CI: -0.1461, 0.2208 and P=0.687), latching (95% CI: -0.3012, 0.0345 and P=0.118) and rooting reflexes (95% CI: -0.1685, 0.2342 and P=0.747) were almost equal in the control group (2.54±0.49, 2.52±0.38, 2.5±0.48, respectively) and pethidine groups (2.51±0.43, 2.65±0.45, 2.46±0.53, respectively). The total score of feeding behavior in the control group (9.66±1.04) was higher than that of the pethidine group (9.44 ±.69) (95% CI: -0.2032, 0.6412 and P=0.306). There was no significant difference between the infants’ feeding frequency (95% CI: -0.269, 1.930 and P=0.137) and duration of feeding (95% CI: -3.2067, 0.4597 and P=0.14). Conclusion: Evaluation of infants in the first 48 hours after birth showed that those babies whose mothers received pethidine were less willing to start breast-feeding. However, other components of breast-feeding behaviors were similar.

Comparison of the effects of Dexamethasone and Ondansetron on the Reduction of Postoperative Nausea and Vomiting following Cesarean Section under Spinal Anesthesia

2020 ◽  
Vol 15 ◽  
Author(s):  
Arash karimi ◽  
Jahanbakhsh Nejadi ◽  
Mahnaz Shamseh ◽  
Nooshin Ronasi ◽  
Mehdi Birjandi
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Postoperative Nausea ◽  
Demographic Data ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Elective Cesarean Section ◽  
Double Blind ◽  
Group A ◽  
Group B

Background: Postoperative nausea and vomiting (PONV) is a common complication associated with the use of anesthesia. Several antiemetics are used to reduce the incidence and severity of PONV. The aim of this study is to investigate the role of dexamethasone and ondansetron to treat PONV in patients undergoing cesarean section (c-section) under spinal anesthesia. Methods: This double-blind clinical trial study was performed on patients who were referred to the operating room of Haji Karim Asali Hospital of Khorramabad for elective cesarean section in 2016-17. Upon meeting the inclusion criteria, patients were allotted into two groups (n=60). Group A received 8mg of dexamethasone and group B received 4mg of ondansetron after spinal anesthesia. The Visual Analog Scale (VAS) questionnaire and Depression-Anxiety-Stress Scale (DASS) questionnaire was used for the analysis. Patients with mild to moderate stress, anxiety, and depression were included in the study. Data were analyzed using SPSS 16 software. Results: There was no difference in the demographic data of the two groups. The mean severity of nausea in group A was significantly higher than in group B. The frequency of vomiting in group A was 20 times higher than group B, which was found to be statistically significant, p = 0.018. Concerning the type of delivery with the frequency of nausea, the results showed that the frequency of nausea in group A was 3.24 times higher than group B, however, this difference was not statistically significant, p = 0.106. Conclusion: Based on the results of this study, ondansetron had a significant effect on the alleviation of postoperative nausea and vomiting, as compared to dexamethasone in c-section surgical candidates.

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