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Intrathecal clonidine does not reduce post-spinal shivering.

Y T Jeon1, Y S Jeon, Y C Kim

  • 1Department of Anesthesiology, Seoul National University Bundang Hospital, Seognam, Seoul, South Korea.

Acta Anaesthesiologica Scandinavica
|October 15, 2005
PubMed
Summary
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Intravenous clonidine effectively prevents post-spinal shivering in orthopedic surgery patients, while intrathecal clonidine does not. Intravenous clonidine also increased patient sedation.

Area of Science:

  • Anesthesiology
  • Pharmacology

Background:

  • Clonidine is recognized for its efficacy in managing established shivering post-anesthesia.
  • Post-spinal anesthesia shivering is a common complication in patients undergoing surgery.

Purpose of the Study:

  • To evaluate the preventive efficacy of intrathecal clonidine against post-spinal shivering.
  • To compare intrathecal clonidine with intravenous clonidine for shivering prevention.

Main Methods:

  • 150 orthopedic surgery patients were randomized into three groups: intravenous clonidine, intrathecal clonidine, or control (saline).
  • Spinal anesthesia was induced with bupivacaine and either saline or clonidine (150 microg intrathecal or 1 microg/kg intravenous).
  • Shivering was assessed and graded over 90 minutes post-anesthesia.

Related Experiment Videos

Main Results:

  • Intravenous clonidine significantly reduced shivering incidence (8%) compared to control (40%) and intrathecal clonidine (34%).
  • Moderate-to-severe shivering was observed only in control and intrathecal groups, with no significant difference in maximal intensity between them.
  • Patients receiving intravenous clonidine experienced significantly greater sedation.

Conclusions:

  • Intrathecal administration of 150 microg clonidine is ineffective in preventing post-spinal shivering.
  • Intravenous clonidine at 1 microg/kg is a confirmed effective method for preventing shivering during spinal anesthesia for orthopedic procedures.