Prophylactic intravenous dexamethasone versus dexmedetomidine for postspinal shivering during lower segment cesarean section: A prospective randomized, double-blind study

Introduction: Shivering is one of the most common encountered little big problems with spinal anesthesia. There are only few published studies comparing intravenous (iv) dexamethasone and dexmedetomidine for the prevention of postspinal shivering (PSS). Aim: The aim of the study is to compare the effectiveness and safety of iv dexamethasone and iv dexmedetomidine in the prevention of PSS during lower segment cesarean section. Methods: Total 160 parturients were randomly allocated into 2 groups by a Sequentially Numbered Opaque Sealed Envelope technique, namely Group Dx and Dm (n = 80). Group Dx received iv dexamethasone 0.1 mg/kg whereas Group Dm received iv dexmedetomidine 1 μg/kg. Incidence of shivering and shivering score were the primary outcomes and the secondary outcomes were sedation score, level of blockade, duration of surgery, axillary temperature, adverse effects, Apgar score, and hemodynamic parameters. Results: Incidence of shivering was significantly low in dexmedetomidine compared to dexamethasone (13.75% vs. 31.25%; P = 0.00468). Group Dx also had comparatively higher shivering score. Overall incidence of sedation was higher in Group Dm compared to Group Dx (15% vs. 3.75%; P = 0.0022). Five parturients in Group Dm (6.25%) had bradycardia compared to none in Group Dx. Respiratory rate, oxygen saturation, and Apgar score were statistically comparable between the 2 Groups. Conclusion: iv dexmedetomidine is more effective in preventing PSS compared to dexamethasone. Additional sedation with dexmedetomidine aids more comfort to the parturients.