Skip to main content Skip to main navigation menu Skip to site footer


Abstract

Background: Shivering can increase oxygen use, the risk of hypoxemia, and post-operative sequelae. The many properties of clonidine make this medication versatile enough to be employed not just to avoid shivering, but also to treat additional spinal anesthesia adverse effects.

Methods: Researchers combed the PubMed database for randomized clinical trials (RCTs) conducted between 2012 and 2022. Each study must be accessible and written in English. Individuals older than 18 who received spinal anesthesia operations.

Results: A total of 41 article abstracts and 12 full-length studies were evaluated, and seven papers met the inclusion criteria. The studied clinical outcome was the frequency of post-spinal anesthesia shivering. The majority of prior investigations found no significant difference in the shivering impact between the clonidine and midazolam groups. Shivering was much less common after tramadol treatment than after clonidine administration. Dexmedetomidine is known to be more effective than clonidine in controlling post-spinal blockade shivering.

Conclusion: Clonidine is beneficial in lowering the occurrence of post-spinal anesthesia shivering.

 

Latar Belakang: Shivering dapat meningkatkan konsumsi oksigen, meningkatkan risiko hipoksemia, dan meningkatkan komplikasi setelah operasi. Berbagai efek klonidin membuat agen ini cukup potensial untuk digunakan tidak hanya sebagai pencegahan shivering tetapi juga untuk mengatasi efek samping lain dari anestesi spinal.

Metode: Peneliti mencari database PubMed untuk uji coba terkontrol acak/randomized clinical trial (RCT) dalam periode 2012-2022. Setiap studi harus dalam bahasa Inggris dan dapat diakses untuk full review. Subjek berusia >18 tahun yang menjalani prosedur anestesi spinal.

Hasil: Total 41 abstrak artikel yang ditelaah, 12 studi full paper ditelaah dan 7 studi yang memenuhi kriteria inklusi. Keluaran klinis yang dievaluasi adalah kejadian shivering pasca anestesi spinal. Hasil sebagian besar studi sebelumnya menunjukkan bahwa tidak terdapat perbedaan bermakna efek shivering pada kelompok klonidin dan midazolam. Insiden shivering pasca pemberian tramadol secara bermakna lebih rendah dibandingkan kelompok klonidin. Pemberian dexmedetomidine diketahui lebih efisien dibandingkan klonidin untuk mengontrol post spinal blockade shivering

Kesimpulan: Klonidin efektif mengurangi kejadian shivering pasca anestesi spinal.

Keywords: Klonidin shivering anestesi spinal

References

  1. Suyasa IK, Ryalino C, Pradnyani NPN. Dexmedetomidine provides better hemodynamic stability compared to clonidine in spine surgery. Bali J Anesthesiol. 2018;2(3):90-94.
  2. Aryabiantara IW, Sinardja IK, Jaya Sutawan IK, Sinardja C, Parami P, Ryalino C, et al. Perioperative effects of co-administration of tci propofol combined with clonidine and ketamine. Bali J Anesthesiol. 2018;2(3):51-55.
  3. Thokchom RS, Binarani M, Singh HK, Singh SS, Singh TH, Praneshwari S. A Comparative Study of Dexmedetomidine and Clonidine in Post Spinal Anaesthesia Shivering. 2018;17(3):15–20.
  4. Park B, Lee T, Berger K, Park SM, Choi KE, Goodsell TM, et al. Efficacy of Nonpharmacological Antishivering Interventions. Crit Care Med. 2015;43(8):1757–1766.
  5. Venkatraman R, Karthik K, Pushparani A, Mahalakshmi A. A prospective, randomized, double-blinded control study on comparison of tramadol, clonidine and dexmedetomidine for post spinal anesthesia shivering. Brazilian J Anesthesiol (English Ed [Internet]. 2018;68(1):42–48.
  6. Tewari A, Dhawan I, Mahendru V, Katyal S, Singh A, Narula N. A comparative study evaluating the prophylactic efficacy of oral clonidine and tramadol for perioperative shivering in geriatric patients undergoing transurethral resection of prostate. J Anaesthesiol Clin Pharmacol. 2014;30(3):340–344.
  7. Wawrzyniak K, Kusza K, Cywinski JB. Comparison of clonidine and midazolam premedication before endoscopic sinus surgery: Results of clinical trial. Clin Exp Otorhinolaryngol. 2014;7(4):307–311.
  8. Gaballah KM, Abdallah SI. Effects of oral premedication with tramadol, pregabalin or clonidine on shivering after spinal anaesthesia in patients undergoing hysteroscopic procedures. Anaesthesiol Intensive Ther. 2020;52(3):187–196.
  9. Vyas V, Gupta R, Dubey P. Comparative efficacy and safety of intravenous clonidine and tramadol for control of postspinal anesthesia shivering. Anesth Essays Res. 2018;12(3):663-668.
  10. Sahi S, Singh MR, Katyal S. Comparative efficacy of intravenous dexmedetomidine, clonidine, and tramadol in postanesthesia shivering. J Anaesthesiol Clin Pharmacol. 2016;32(2):240–244.
  11. Panneer M, Murugaiyan P, Rao S. A comparative study of intravenous dexmedetomidine and intravenous clonidine for postspinal shivering in patients undergoing lower limb orthopedic surgeries. Anesth Essays Res. 2017;11(1):151-154.
  12. Glaess SS, Attridge RL, Christina Gutierrez G. Clonidine as a strategy for discontinuing dexmedetomidine sedation in critically ill patients: A narrative review. Am J Health Syst Pharm. 2020;77(7):515-522.
  13. Khakurel S, Sapkota S, Karki AJ. Analgesic Effect of Caudal Bupivacaine with or without Clonidine in Pediatric Patient. J Nepal Health Res Counc. 2019;16(41):428–433.
  14. Drugs for ADHD. Med Lett Drugs Ther. 2020;62(1590):9–15.
  15. Mangkung T, Parami P, Budiarta Ig, Agung Senapathi T. Clonidine 0.5 μg/kg intravenous as prevention of shivering after spinal anesthesia in cesarean section. Bali J Anesthesiol. 2020;4(3):136-139.
  16. Gracia CZ, Hanafie A, Nasution AH. Comparison of hemodynamic response between propofol and thiopental as an induction agent in neurosurgery anesthesia at Haji Adam Malik General Hospital Medan-Indonesa. Bali Medical Journal. 2018;7(3):717-722.
  17. Wicaksono SA, Nugroho RK, Nugroho TE, Sutiyono D, Leksana E, Utami SB. Clonidine premedication was better in preventing hemodynamic response changes post laryngoscopy and endotracheal intubation compared to fentanyl premedication. Bali Medical Journal. 2023;12(1):1041-1048.
  18. Wijanarko B, Sumartono C, Wirabuana B, Hardiono, Semedi BP, Airlangga PS, et al. Effects of Tourniquet Inflation on Blood Pressure, Mean Arterial Pressure, and Pulse Rate during the Maintenance of Anesthesia Using a Combination of Dexmedetomidine and Isoflurane for Patients Undergoing Lower Extremity Surgery. Bali Medical Journal. 2023;12(1):1033-1040.

How to Cite

Arthana, I. N. D. A. . (2023). Penggunaan klonidin sebagai terapi shivering pasca anestesi spinal: sebuah tinjauan sistematis. Intisari Sains Medis, 14(2), 658–663. https://doi.org/10.15562/ism.v14i2.1736
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver
Download Citation
Endnote/Zotero/Mendeley (RIS) BibTeX

HTML
0

Total
0

Share

Search Panel

I Nyoman Dwi Ari Arthana
Google Scholar
Pubmed
ISM Journal