A Comparative Study to Assess the Efficacy and Safety of Intrathecal Bupivacaine Alone, Intrathecal Bupivacaine Plus Dexmedetomidine and Intrathecal Bupivacaine Plus Magnesium Sulphate for the Prevention of Post-Spinal Anaesthesia Shivering in Transurethr

Abstract

Background: Preventing the post spinal shivering that occurs frequently in patients undergoing TURP would be beneficial. This trial aimed at evaluating the affect of intrathecal Mgso4 and dexmedetomidine in terms of incidence and intensity of shivering. Methods: This prospective randomized, double-blinded control study enrolled Seventy five patients randomized in three groups. All patients received standard spinal anaesthesia with 2.5ml of hyperbaric bupivacaine heavy 0.5% (12.5mg). Group A- received 0.5ml of normal saline, Group B- received 5μg dexmedetomidine in 0.5ml saline, and Group C- received 25mg MgSO4 in 0.5ml saline in addition to hyperbaric bupivacaine. The primary objectives of this study were incidence and intensity of shivering, while secondary objective were total dose of Pethidine required to control Shivering, Sedation score and Complications including Hypotension, bradycardia, Nausea, Vomiting. All data were summarized as mean ± SD for continuous variables, numbers and percentages for categorical variables. P <0.05 was accepted as statistically significant. Results: incidence of post spinal anaesthesia shivering was statistically significant in group A (56%) as compare to group B (12%) and group C (32%). The shivering grades of the groups A and C were statistically significant (P<0.001) and B was not significant (P>0.05). Nausea, vomiting, bradycardia and hypotension were comparable between the groups. All patients in group A, 22 patients in group B, and 21patients in group C had sedation score of 2. Three patients in group B and four in group C had a sedation score of 3. Conclusion: Intrathecal injection of dexmedetomidine and MgSO4 with bupivacaine were effective in reducing the incidence as well as intensity of post-SA shivering.