Nalbuphine versus dexmedetomidine for treatment of combined spinal-epidural post-anesthetic shivering in pregnant women undergoing cesarean section

J Int Med Res. 2019 Sep;47(9):4442-4453. doi: 10.1177/0300060519865063. Epub 2019 Jul 29.

Abstract

Objective: This study aimed to compare the clinical efficacy and side effects of nalbuphine and dexmedetomidine for treatment of combined spinal-epidural anesthetic shivering in women after cesarean section.

Methods: A total of 120 pregnant women, who underwent elective cesarean section under combined spinal-epidural anesthesia, were enrolled in a double-blind, randomized study. These women were randomized into three groups of 40 pregnant women each to receive either saline (group C), nalbuphine 0.07 mg/kg (group N), or dexmedetomidine 0.5 µg/kg (group D) for treatment of shivering after anesthesia. The main outcome measure was a significant reduction in the time required for shivering after intervention.

Results: The mean time to cessation of shivering in groups N and D was significantly shorter than that in group C (3.5±2.7 and 4.2±3.7 versus 14.5±1.4 minutes). The success rate of shivering treatment and Observer’s Assessment of Alertness/Sedation scores in groups N and D were significantly higher than those in group C, while the recurrence rate was lower than that in group C.

Conclusion: Nalbuphine 0.07 mg/kg can be used safely and effectively for shivering in pregnant women under combined spinal-epidural anesthesia.

Keywords: Nalbuphine; caesarean section; combined spinal-epidural anesthesia; dexmedetomidine; pregnant woman; shivering.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anesthesia, Epidural / adverse effects*
  • Anesthesia, Spinal / adverse effects*
  • Blood Glucose / metabolism
  • Cesarean Section / adverse effects*
  • Dexmedetomidine / pharmacology
  • Dexmedetomidine / therapeutic use*
  • Female
  • Humans
  • Insulin / blood
  • Nalbuphine / pharmacology
  • Nalbuphine / therapeutic use*
  • Postoperative Complications / etiology
  • Pregnancy
  • Shivering* / drug effects
  • Time Factors
  • Treatment Outcome
  • Uterine Contraction / drug effects
  • Visual Analog Scale

Substances

  • Blood Glucose
  • Insulin
  • Dexmedetomidine
  • Nalbuphine