Perbandingan Dexmedetomidine dengan Dexamethasone Intravena sebagai Pencegahan Menggigil setelah Spinal Anestesi pada Operasi Sectio Caesaria

Abstract

Introduction: Postspinal anesthesia shivering (PSAS) is an involuntary and repetitive skeletal muscle activity as a physiological response to core hypothermia to increase metabolic heat production. PSAS increases O2 consumption, CO2 production, plasma catecholamines, and cardiac output. It is imperative to keep the patient normothermic by non-pharmacologic methods such as warming the skin surface and warming the administered fluids. Commonly used pharmacologic therapies are dexmedetomidine and dexamethasone. Dexmedetomidine reduces the incidence of shivering through increased vasodilation and inhibition of central thermoregulation. Dexamethasone is known to modify the body's inflammatory reaction and reduce the gradient between central and peripheral tissue temperature. This study was conducted to compare dexmedetomidine and intravenous dexamethasone as prevention of shivering after spinal anesthesia in cesarean section surgery. Methods: This study design uses a double-blind randomized controlled clinical trial, to assess the comparison of dexmedetomidine and intravenous dexamethasone as prevention of shivering. The selected population will be randomly divided into two groups, the dexmedetomidine and dexamethasone administration groups. Then, hemodynamic parameters in both groups were assessed and the intensity of shivering was assessed using a five-point scale validated by Crossley and Mahajan, where degree 0 = no shivering, degree 1 = piloerection or peripheral vasoconstriction but no visible shivering, degree 2 = muscle activity in only one muscle group, degree 3 = muscle activity in more than one muscle group, and degree 4 = whole body shivering. The collected data were processed and statistically analyzed using statistical product and service solution (SPSS) windows program. Results: In the comparison of the two treatment groups, it was found that the number of samples who experienced the most chills was in group B as many as 17 (31,5%) people compared to group A as many as 6 (11,1%) people. In the chisquare test analysis, the p value <0.05 was obtained, indicating that the difference in the values of the two groups was statistically significant. Conclusion: Dexmedetomidine is better at preventing shivering than dexamethasone.