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Urapidil does not prevent postanesthetic shivering: a dose-ranging study

[L'urapidil n'empêche pas le frisson postanesthésique : une étude de dosage]

From the Department of Anesthesiology and Intensive Care Medicine, Klinikum Ludwigshafen, Ludwigshafen, Germany.

Address correspondence to: Dr. Swen N. Piper, Department of Anesthesiology and Intensive Care Medicine, Klinikum Ludwigshafen, Bremserstraße 79 D-67063, Ludwigshafen, Germany. Phone: 0049-621-503-3000; Fax: 0049-621-503-3024; E-mail: wolfgang_maleck{at}hotmail.com

Purpose: To investigate the effect of 0.2 mg•kg^–1, 0.3 mg•kg^–1 and 0.4 mg•kg^–1 urapidil on the incidence and severity of postanesthetic shivering.

Methods: One hundred and fifty patients (ASA I–III) scheduled for elective abdominal, urologic or orthopedic surgery under standardized general anesthesia were randomly allocated to one of five groups (each group n=30) using a double-blind protocol: group A received 0.2 mg•kg^–1 urapidil, group B: 0.3 mg•kg^–1 urapidil, group C: 0.4 mg•kg^–1 urapidil, group D: 3 µg•kg^–1 clonidine (positive control group), and group E: saline 0.9% as placebo (negative control group). Postanesthetic shivering was scored using a five-point scale.

Results: Twelve patients of group A, 11 of group B, nine of group C, three of group D and 14 of group E showed signs of postanesthetic shivering. Postanesthetic shivering was significantly decreased in the clonidine group compared to the three urapidil groups and the placebo group. Significantly less patients treated with clonidine needed anti-shivering therapy. There were no significant differences between the urapidil and placebo groups. Therapeutic interventions for hemodynamic effects were not required in any group. Time to extubation, but not time to discharge, was prolonged in the clonidine group.

Conclusion: Urapidil showed no beneficial effect on shivering in any of the doses evaluated, whereas prophylactic administration of clonidine was effective in preventing postanesthetic shivering.

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