Intravenous Dexmedetomidine Vs. Meperidine for Managing Shivering After Spinal Anesthesia in Cesarean Deliveries: A Randomized Trial Publisher



Manouchehrian N ; Mortazavi A ; Mehrabani MN
Source: Perioperative Care and Operating Room Management Published:2025

Abstract

Background: Post-spinal anesthesia shivering is a common complication during cesarean delivery, causing patient discomfort and interfering with vital sign monitoring. Objectives: This study compared the efficacy and safety of intravenous dexmedetomidine and meperidine for controlling post-spinal anesthesia shivering in cesarean deliveries. Methods: In this randomized clinical trial, 246 parturients who developed shivering after spinal anesthesia were allocated to two groups. Group A received intravenous meperidine (0.5 mg/kg), and Group B received dexmedetomidine (0.5 µg/kg), both administered over 10 min after umbilical cord clamping. Shivering intensity, vital signs, and adverse effects were recorded and analyzed. Results: The onset time of shivering was similar between groups (P = 0.081). The time to cessation of shivering was significantly shorter in the meperidine group (7.6 ± 4.6 min) compared to the dexmedetomidine group (9.7 ± 5.5 min) (P = 0.003). Shivering scores at 5- and 10-minute post-injection were significantly lower in the meperidine group (P < 0.05). Blood pressure was lower and heart rate higher in the meperidine group at early time points (P < 0.05), but these changes were transient and not clinically significant. Dexmedetomidine was associated with higher rates of bradycardia and hypertension (P = 0.001 and P = 0.005), while nausea and vomiting were more frequent with meperidine (P = 0.166). Meperidine demonstrated a faster time to shivering cessation, while dexmedetomidine had lower rates of nausea and vomiting. Conclusion: Both drugs effectively controlled post-spinal anesthesia shivering. Meperidine demonstrated a faster time to shivering cessation, while dexmedetomidine had lower rates of nausea and vomiting. Further studies are needed to optimize dosing and assess long-term outcomes © 2025 Elsevier B.V., All rights reserved.