INTRATHECAL DEXMEDETOMIDINE USE IN SHIVERING PREVENTION: A SYSTEMATIC REVIEW OF RANDOMIZED CLINICAL TRIALS

Shivering is a common postoperative complication and can lead to important interferences in monitorization, in addition to causing discomfort to the patient and increased oxygen consumption. Although frequently related to hypothermia, it can occur in normothermic patients, a fact that raises the imp...

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Principais autores: Rego Vasconcelos, Amanda, Medeiros, Heitor, Pereira Trevisan, Lucas, Klenio Confessor de Souza, Raphael, Andrino da Silva, Wallace
Formato: Online
Idioma:eng
Publicado em: FEDERAL UNIVERSITY OF RIO GRANDE DO NORTE, BRAZIL
Endereço do item:https://periodicos.ufrn.br/jscr/article/view/32818
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spelling oai:periodicos.ufrn.br:article-328182023-07-28T16:41:19Z INTRATHECAL DEXMEDETOMIDINE USE IN SHIVERING PREVENTION: A SYSTEMATIC REVIEW OF RANDOMIZED CLINICAL TRIALS Rego Vasconcelos, Amanda Medeiros, Heitor Pereira Trevisan, Lucas Klenio Confessor de Souza, Raphael Andrino da Silva, Wallace intrathecal dexmedetomidine intrathecal adjuvant shivering spinal anesthesia Shivering is a common postoperative complication and can lead to important interferences in monitorization, in addition to causing discomfort to the patient and increased oxygen consumption. Although frequently related to hypothermia, it can occur in normothermic patients, a fact that raises the importance of using pharmacological strategies for its prophylaxis and treatment. The effectiveness of alpha-2 agonists in preventing this entity has been extensively studied, mainly dexmedetomidine due to its greater selectivity to alpha-2 receptors. Many studies have shown that its intravenous infusion is capable of preventing post-anesthetic shivering, however its use has been questioned due to its possible side effects. Intrathecal administration, on the other hand, has been evaluated as an effective adjuvant drug to local anesthetics. Therefore, this study aims to review the evidence of the intrathecal use of dexmedetomidine as an adjuvant drug in spinal anesthesia to prevent shivering. A search was performed in the MEDLINE database accessed through PubMed and Biblioteca Virtual em Saúde (BVS), which resulted in seven randomized clinical trials presented in this work. They show a significant reduction in the incidence and intensity of shivering after spinal block with the use of five micrograms of intrathecal dexmedetomidine, in addition to promoting an increase in the duration of motor and sensory blocks. However, further studies are still needed to ensure that the hemodynamic repercussions are not significant. FEDERAL UNIVERSITY OF RIO GRANDE DO NORTE, BRAZIL 2023-07-17 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://periodicos.ufrn.br/jscr/article/view/32818 JOURNAL OF SURGICAL AND CLINICAL RESEARCH; Vol. 14 No. 1 (2023); 53-62 JOURNAL OF SURGICAL AND CLINICAL RESEARCH; v. 14 n. 1 (2023); 53-62 2179-7889 eng https://periodicos.ufrn.br/jscr/article/view/32818/17218 Copyright (c) 2023 JOURNAL OF SURGICAL AND CLINICAL RESEARCH http://creativecommons.org/licenses/by-nc-sa/4.0
institution Periódicos UFRN
collection Portal de Pediódicos Eletrônicos da UFRN
language eng
format Online
author Rego Vasconcelos, Amanda
Medeiros, Heitor
Pereira Trevisan, Lucas
Klenio Confessor de Souza, Raphael
Andrino da Silva, Wallace
spellingShingle Rego Vasconcelos, Amanda
Medeiros, Heitor
Pereira Trevisan, Lucas
Klenio Confessor de Souza, Raphael
Andrino da Silva, Wallace
INTRATHECAL DEXMEDETOMIDINE USE IN SHIVERING PREVENTION: A SYSTEMATIC REVIEW OF RANDOMIZED CLINICAL TRIALS
author_facet Rego Vasconcelos, Amanda
Medeiros, Heitor
Pereira Trevisan, Lucas
Klenio Confessor de Souza, Raphael
Andrino da Silva, Wallace
author_sort Rego Vasconcelos, Amanda
title INTRATHECAL DEXMEDETOMIDINE USE IN SHIVERING PREVENTION: A SYSTEMATIC REVIEW OF RANDOMIZED CLINICAL TRIALS
title_short INTRATHECAL DEXMEDETOMIDINE USE IN SHIVERING PREVENTION: A SYSTEMATIC REVIEW OF RANDOMIZED CLINICAL TRIALS
title_full INTRATHECAL DEXMEDETOMIDINE USE IN SHIVERING PREVENTION: A SYSTEMATIC REVIEW OF RANDOMIZED CLINICAL TRIALS
title_fullStr INTRATHECAL DEXMEDETOMIDINE USE IN SHIVERING PREVENTION: A SYSTEMATIC REVIEW OF RANDOMIZED CLINICAL TRIALS
title_full_unstemmed INTRATHECAL DEXMEDETOMIDINE USE IN SHIVERING PREVENTION: A SYSTEMATIC REVIEW OF RANDOMIZED CLINICAL TRIALS
title_sort intrathecal dexmedetomidine use in shivering prevention: a systematic review of randomized clinical trials
description Shivering is a common postoperative complication and can lead to important interferences in monitorization, in addition to causing discomfort to the patient and increased oxygen consumption. Although frequently related to hypothermia, it can occur in normothermic patients, a fact that raises the importance of using pharmacological strategies for its prophylaxis and treatment. The effectiveness of alpha-2 agonists in preventing this entity has been extensively studied, mainly dexmedetomidine due to its greater selectivity to alpha-2 receptors. Many studies have shown that its intravenous infusion is capable of preventing post-anesthetic shivering, however its use has been questioned due to its possible side effects. Intrathecal administration, on the other hand, has been evaluated as an effective adjuvant drug to local anesthetics. Therefore, this study aims to review the evidence of the intrathecal use of dexmedetomidine as an adjuvant drug in spinal anesthesia to prevent shivering. A search was performed in the MEDLINE database accessed through PubMed and Biblioteca Virtual em Saúde (BVS), which resulted in seven randomized clinical trials presented in this work. They show a significant reduction in the incidence and intensity of shivering after spinal block with the use of five micrograms of intrathecal dexmedetomidine, in addition to promoting an increase in the duration of motor and sensory blocks. However, further studies are still needed to ensure that the hemodynamic repercussions are not significant.
publisher FEDERAL UNIVERSITY OF RIO GRANDE DO NORTE, BRAZIL
publishDate 2023
url https://periodicos.ufrn.br/jscr/article/view/32818
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