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Abstract

Background: Post-spinal anesthesia shivering (PSAS) is a common complication affecting patient comfort and surgical outcomes. This study evaluated the effectiveness and safety of dexmedetomidine in managing PSAS in patients undergoing lower abdominal surgeries.
Methods: A prospective, double-blind study was conducted on 60 adult patients (ASA I-II, aged 20-45 years) who developed shivering following spinal anesthesia for elective lower abdominal surgery. Patients were randomly allocated to receive either intravenous dexmedetomidine 0.5 mcg/kg (Group D, n=30) or normal saline (Group S, n=30) over 10 minutes. Primary outcome was time to cessation of shivering. Secondary outcomes included shivering intensity scores, hemodynamic parameters, body temperature changes, and adverse events.
Results: Demographic characteristics were comparable between groups. Dexmedetomidine demonstrated superior efficacy with significantly lower mean shivering scores (1.05 ± 0.67 vs 3.3 ± 0.73, p < 0.0001) and faster cessation times (2.37 ± 0.36 vs 3.81 ± 0.31 minutes, p < 0.0001). Group D showed controlled reductions in systolic blood pressure, diastolic blood pressure, and heart rate compared to controls, with all changes remaining clinically acceptable. Core body temperature was preserved in both groups with no significant differences. No serious adverse events were observed.
Conclusion: Intravenous dexmedetomidine at 0.5 mcg/kg effectively controls post-spinal anesthesia shivering with rapid onset, predictable hemodynamic effects, and excellent safety profile. These findings support its integration into evidence-based protocols for perioperative thermoregulation management in patients undergoing lower abdominal surgeries under spinal anesthesia