Intravenous Bolus of Dexmedetomidine for Treatment of Severe Shivering After Caesarean Delivery Under Combined Spinal-Epidural Anaesthesia: A Randomized Dose-Response Study

Abstract

Purpose

Shivering occurs frequently after caesarean delivery. The present study aimed to investigate the ED50 and ED95 of an intravenous (i.v.) bolus of dexmedetomidine for treating severe shivering after caesarean delivery under combined spinal-epidural anaesthesia.

Patients and methods

Seventy-five parturients with severe shivering after caesarean delivery were randomized into one of the five groups to receive an i.v. bolus of 0.2 (Group D1), 0.25 (Group D2), 0.3 (Group D3), 0.35 (Group D4) or 0.4 (Group D5) μg/kg of dexmedetomidine. Effectiveness of shivering treatment was defined as a standardized shivering score decreasing to ≤1 within 10 min of dexmedetomidine injection. The ED50 and ED95 were determined by probit regression. Adverse effects were also compared among the groups.

Results

The ED50 and ED95 of i.v. dexmedetomidine to treat severe shivering were 0.23 (95% CI, 0.16–0.26) μg/kg and 0.39 (95% CI, 0.34–0.52) μg/kg, respectively. No difference in the incidence of adverse effects was found between groups.

Conclusion

An i.v. bolus of 0.39 μg/kg of dexmedetomidine will treat 95% of parturients experiencing severe shivering after caesarean delivery.

Keywords:

• dexmedetomidine
• shivering
• caesarean delivery

Data Sharing Statement

We are committed to sharing the raw data collected during the clinical trial, including demographic information, clinical measurements, and treatment outcomes. The data can be obtained from the corresponding author ([email protected]) on reasonable request. Access to the data will be granted for research purposes only and is subject to compliance with applicable ethical guidelines and data protection regulations. Prior permission is required for any commercial use or sharing of the data. The data will be released upon publication of the manuscript and will remain accessible for a period of 2 years after publication.

Ethics and Consent Statements

Our research was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. Informed consent was obtained from all participants who joined the study, and approval for the study protocol was granted by the relevant institutional review board and ethics committee. We ensured confidentiality and privacy of participant data throughout the study while adhering to all applicable data protection regulations.

Acknowledgments

Mei-Juan Yang and Shu-Xi Li contributed equally to this work. The authors thank all the staff of the Department of Anesthesia and Operation Theatre, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China, for their help with this study. This study was supported by grants from the National Natural Science Foundation of China (81471126, 81870868).

Disclosure

The authors declare no conflicts of interest in this work.