Abstract
Purpose
Postanaesthetic shivering occurs in 5–65% of patients. In addition to causing discomfort. it is associated with deleterious consequences. Our objective was to investigate the effect of 150μg clonidine, at induction of anaesthesia, on penoperative core and peripheral temperature, incidence of postanaesthetic shivering and patients’ perception of cold.
Methods
Sixty ASA 1 or 2 patients scheduled for elective orthopaedic limb surgery were randomly allocated to group 1. who received 150μg clonidineiv, or group 2, who received a saline bolusiv. before induction. In all patients, anaesthesia was induced with fentanyl and propofol and maintained by spontaneous respiration (via a laiyngeal mask airway) of oxygen, nitrous oxide and enflurane. Core (nasopharyngeal) and peripheral (dorsal hand) temperatures were recorded at induction and 15-min intervals. Nurses, unaware of the treatment groups, recorded visible shivering in the recovery room. When cognitive function returned, patients were asked to grade their perception of cold on a 10 cm linear analogue scale, higher scores indicating heat discomfort.
Results
While core temperature decreased and peripheral temperature increased in both groups, there was no difference between the groups at any time. However, there was a lower incidence of shivering in the clonidine group (20%vs 66.7%,P < 0.001). Patients receiving clonidine felt warmer; thermal comfort score (median interquartile range) 5.9 (5.0–7.2)vs 5.0 (4.5–6.0),P < 0.05).
Conclusion
Clonidine 150 giv at induction of anaesthesia reduces the incidence of shivering and patients’ subjective perception of cold on emergence from general anaesthesia.
Résumé
Objectif
Le frisson survient chez 5% à 65% des patients après l’anesthésie. En plus d’incommoder, le frisson a des conséquences nocives. Cette étude visait à étudier les effets de la clonidine 150μg administrée à l’induction de l’anesthésie sur les températures périphériques et centrales, l’incidence du frisson postanesthésique et la façon dont le patient perçoit le froid.
Méthodes
Soixante patients ASA 1 et 2 programmés pour une intervention orthopédique sur les membres avaient été répartis au hasard: avant l’induction, le groupe I recevait 150 μg de clonidineiv et le groupe 2 recevait un bolus de sol.phys. L’anesthésie était toujours induite au fentanyl avec propofol et maintenue au protoxyde d’azote et à l’enflurane. Les températures centrales (pharyngées) et pénphériques (dos de la main) étaient enregistrées à l’induction et à des intervalles de cinq minutes par la suite. Des infirmières, ignorant le groupe du patient, enregistraient le frisson apparent en salle de réveil. Au retour des fonctions cognitives, on demandait aux patients d’évaluer leur perception du froid sur une échelle visuelle analogique de 10 cm, les scores élevés étant attribués selon l’importance du malaise provoqué par le froid.
Résultats
Alors que la température centrale diminuait et la température pénphénque augmentait dans les deux groupes, aucune différence n’était notée entre les groupes. Cependant, l’incidence du fnsson était plus basse dans le groupe clonidine (20%vs 66.7%,P < 0,001). La perception de chaleur était plus élevée chez les patients sous clonidine avec un score de comfort (médiane écart interquartile de) 5,9 (5.0–7.2)vs 5.0 (4.5–6,0),P < 0,05).
Conclusion
Administrée à l’induction, la clonidineiv réduit l’incidence du frisson et la sensation subjective de froid perçue au réveil après une anesthésie générale.
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Buggy, D., Higgins, P., Moran, C. et al. Clonidine at induction reduces shivering after general anaesthesia. Can J Anaesth 44, 263–267 (1997). https://doi.org/10.1007/BF03015363
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DOI: https://doi.org/10.1007/BF03015363