Post Spinal ShiveringPhase 2NCT05616364
Compair Efficacy of iv Dexmedetomidine & Tramadol for Post Spinal Shivering in Obs Patients Undergoing Cesarean Section
A Phase 2 study testing Dexmedetomidine injection and Tramadol in people with Post Spinal Shivering, run by Sana Bahadur.
Trial summary
When opposed to GA,SA is recommended during c section. Shivering is more prevalent and inconvenient complication of spinal anaesthesia, with 40 to 70% incidence rate. Tramadol has been proven to be beneficial in preventing post spinal shivering. Read more about this study
- Who is it for?
- Ages 18 to 38 years, women onlyHealthy volunteers can take part
- Conditions the study is for
- Post Spinal Shivering
- What is being tested?
- Dexmedetomidine injection and Tramadol
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 100 participants
- Where
- No sites listed yet
- Study dates
- Mar 2023to Feb 2025
- Phase
- Phase 2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 38 years
- Women only
- Healthy volunteers accepted
- Adult
Who may be able to join
- Patient who will give consent
- ASA 2 patients
- Female gender of age 18 to 38
Who cannot join
- Patient allergic to any drugs
- Uncontrolled HTN
- Antepartum
- Cardiomyopathy
- Peripartum haemorrhage
- Eclampsia
- Patients refuse to give consent
About this study
Official title: Comparison of the Efficacy of Intravenous Dexmedetomidine and Tramadol in Control of Post Spinal Shivering in Obstetric Patients Undergoing Lower Segment Cesarean Section
When opposed to GA,SA is recommended during c section. Shivering is more prevalent and inconvenient complication of spinal anaesthesia, with 40 to 70% incidence rate. Tramadol has been proven to be beneficial in preventing post spinal shivering. Dexmedetomidine is a sedative, analgesic, anxiolytic, sympatholytic and opioid-sparing alpha adrenergic agonist. It has been shown to lower the threshold for shivering. The study aims to search for best drug for blunting shivering response.
Read the detailed description
When opposed to general anaesthesia (GA), spinal anaesthesia (SA) is recommended during caesarean section (CS) because of various advantages, including the prevention of GA-related neurotoxicity, its early onset and ease of administration, and the reduction of post-operative pain. Intraoperative shivering is the most prevalent irritating and inconvenient complication of spinal anaesthesia, and it is a very distressing experience that causes physiological stress to both patients and perioperative physicians and operating surgeons. Shivering is a skeletal muscular movement that occurs involuntarily and repeatedly. It's a common post-anesthesia adverse effect, with a 40-70% incidence rate.Shivering is not only physically unpleasant for the sufferer, but it can also have several negative consequences. It can cause pain, and discomfort for patients, obstruct monitoring techniques, raise intraocular and intracranial pressures, and double or even triple oxygen and carbon dioxide intake.Various pharmacological and non-pharmacological strategies for managing intraoperative shivering are discussed.
Tramadol, a centrally acting analgesic with -opioid agonist properties and little action on kappa and delta receptors, has been proven to be beneficial in preventing post-spinal shivering. The method of action is thought to be through a modulatory influence on central monoaminergic pathways, which inhibits noradrenaline and serotonin neuronal absorption in the spinal cord while boosting hydroxyltryptamine production, resetting the body temperature regulatory center.However, it has many side effects, including nausea, vomiting, and dizziness, which add to the patient's pain. Hence research into novel solutions with adequate safety and effectiveness is strongly advised. In this sense, despite taking into account the gold standard for post spinal shivering control is pethidine. it is contraindicated in breastfeeding which is both legally and ethically challenging for women.
Dexmedetomidine is a sedative, analgesic, anxiolytic, sympatholytic, and opioid-sparing alpha 2 adrenergic agonist with good selectivity and specificity.It has been shown to lower the threshold for shivering.Dexmedetomidine does not affect the locus ceruleus of the spinal cord, and it does not cause respiratory depression. In postoperative patients, dexmedetomidine lowers cortisol and norepinephrine levels, as well as blood glucose, interleukin (IL)-6, tumour necrosis factor-a, and C-reactive protein, and raises interleukin-10. Moreover, because Dexmedetomidine does not affect upper airway reflexes, it is an excellent option.It was believed that the sedative impact of intravenous injection on newborn infants was very minimal and could be disregarded due to the delayed sedative effects.
These drugs have well-defined roles to blunt the "shivering response" and hence have been used in different comparative studies to develop the single best drug of choice. Yet, there is no consensus over a single drug. In our research, we intend to compare IV Tramadol and IV Dexmedetomidine for controlling post spinal shivering in obstetric patients. The study aims to search for the best drug for blunting the shivering response, which may prove fatal in any patient.
- Conditions
- Post Spinal Shivering
- Being tested
- Dexmedetomidine injection, Tramadol
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Dexmedetomidine injectionDrug
Dexmedetomidine intravenous
TramadolDrug
Tramadol intravenous
| Study group | Role | What they receive |
|---|---|---|
| Dexmedetomidine | Experimental | Dexmedetomidine is a sedative, analgesic, anxiolytic, sympatholytic, and opioid-sparing alpha 2 adrenergic agonist with good selectivity and specificity.It has been shown to lower the threshold for shivering. Dexmedetomidine does not affect the locus ceruleus of the spinal cord, and it does not cause respiratory depression. [8] In postoperative patients, dexmedetomidine lowers cortisol and norepinephrine levels, as well as blood glucose, interleukin (IL)-6, tumour necrosis factor-a, and C-reactive protein, and raises interleukin-10. Moreover, because Dexmedetomidine does not affect upper airway reflexes, it is an excellent option.It was believed that the sedative impact of intravenous injection on newborn infants was very minimal and could be disregarded due to the delayed sedative effects Receives: Drug: Dexmedetomidine injection |
| Tramadol | Experimental | Tramadol, a centrally acting analgesic with -opioid agonist properties and little action on kappa and delta receptors, has been proven to be beneficial in preventing post-spinal shivering. The method of action is thought to be through a modulatory influence on central monoaminergic pathways, which inhibits noradrenaline and serotonin neuronal absorption in the spinal cord while boosting hydroxyltryptamine production, resetting the body temperature regulatory center. [3] However, it has many side effects, including nausea, vomiting, and dizziness, which add to the patient's pain. [5] Hence research into novel solutions with adequate safety and effectiveness is strongly advised. In this sense, despite taking into account the gold standard for post spinal shivering control is pethidine. it is contraindicated in breastfeeding which is both legally and ethically challenging for women. Receives: Drug: Tramadol |
What is being measured
The primary outcome is the main question the study is designed to answer.
Assessment of post spinal shivering by observing grades of shivering
Control of post spinal shivering Dexmedetomidine and tramadol for post spinal shivering
Measured: 10 minutes
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Nov 2022
- Study startMar 2023 (estimated)
- Primary completionMar 2024 (estimated)
- Study completionFeb 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Post Spinal ShiveringStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 100 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Sana Bahadur
- Sponsor type
- Other government
- Responsible party
- Sponsor-investigator, Sana Bahadur, Sheikh Zayed Medical College
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05616364
- Sponsor's protocol ID
- Sheikh Zayed Medical College &
- Status last verified
- Nov 2022
- First submitted
- 9 Oct 2022
- Last updated
- 15 Nov 2022
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 15 Nov 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of the Efficacy of Intravenous Dexmedetomidine and Tramadol in Control of Post Spinal Shivering in Obstetric Patients Undergoing Lower Segment Cesarean Section
- ClinicalTrials.gov ID
- NCT05616364
- Acronym / sponsor ID
- Sheikh Zayed Medical College &
- Conditions
- Post Spinal Shivering
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 100 participants (estimated)
- Lead sponsor
- Sana BahadurOther government
- Study start
- Mar 2023 (estimated)
- Primary completion
- Mar 2024 (estimated)
- Study completion
- Feb 2025 (estimated)
- First posted
- 15 Nov 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
When opposed to GA,SA is recommended during c section. Shivering is more prevalent and inconvenient complication of spinal anaesthesia, with 40 to 70% incidence rate. Tramadol has been proven to be beneficial in preventing post spinal shivering. Dexmedetomidine is a sedative, analgesic, anxiolytic, sympatholytic and opioid-sparing alpha adrenergic agonist. It has been shown to lower the threshold for shivering. The study aims to search for best drug for blunting shivering response.
Detailed description
When opposed to general anaesthesia (GA), spinal anaesthesia (SA) is recommended during caesarean section (CS) because of various advantages, including the prevention of GA-related neurotoxicity, its early onset and ease of administration, and the reduction of post-operative pain. Intraoperative shivering is the most prevalent irritating and inconvenient complication of spinal anaesthesia, and it is a very distressing experience that causes physiological stress to both patients and perioperative physicians and operating surgeons. Shivering is a skeletal muscular movement that occurs involuntarily and repeatedly. It's a common post-anesthesia adverse effect, with a 40-70% incidence rate.Shivering is not only physically unpleasant for the sufferer, but it can also have several negative consequences. It can cause pain, and discomfort for patients, obstruct monitoring techniques, raise intraocular and intracranial pressures, and double or even triple oxygen and carbon dioxide intake.Various pharmacological and non-pharmacological strategies for managing intraoperative shivering are discussed.
Tramadol, a centrally acting analgesic with -opioid agonist properties and little action on kappa and delta receptors, has been proven to be beneficial in preventing post-spinal shivering. The method of action is thought to be through a modulatory influence on central monoaminergic pathways, which inhibits noradrenaline and serotonin neuronal absorption in the spinal cord while boosting hydroxyltryptamine production, resetting the body temperature regulatory center.However, it has many side effects, including nausea, vomiting, and dizziness, which add to the patient's pain. Hence research into novel solutions with adequate safety and effectiveness is strongly advised. In this sense, despite taking into account the gold standard for post spinal shivering control is pethidine. it is contraindicated in breastfeeding which is both legally and ethically challenging for women.
Dexmedetomidine is a sedative, analgesic, anxiolytic, sympatholytic, and opioid-sparing alpha 2 adrenergic agonist with good selectivity and specificity.It has been shown to lower the threshold for shivering.Dexmedetomidine does not affect the locus ceruleus of the spinal cord, and it does not cause respiratory depression. In postoperative patients, dexmedetomidine lowers cortisol and norepinephrine levels, as well as blood glucose, interleukin (IL)-6, tumour necrosis factor-a, and C-reactive protein, and raises interleukin-10. Moreover, because Dexmedetomidine does not affect upper airway reflexes, it is an excellent option.It was believed that the sedative impact of intravenous injection on newborn infants was very minimal and could be disregarded due to the delayed sedative effects.
These drugs have well-defined roles to blunt the "shivering response" and hence have been used in different comparative studies to develop the single best drug of choice. Yet, there is no consensus over a single drug. In our research, we intend to compare IV Tramadol and IV Dexmedetomidine for controlling post spinal shivering in obstetric patients. The study aims to search for the best drug for blunting the shivering response, which may prove fatal in any patient.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Dexmedetomidine | Experimental | Drug: Dexmedetomidine injectionDexmedetomidine is a sedative, analgesic, anxiolytic, sympatholytic, and opioid-sparing alpha 2 adrenergic agonist with good selectivity and specificity.It has been shown to lower the threshold for shivering. Dexmedetomidine does not affect the locus ceruleus of the spinal cord, and it does not cause respiratory depression. [8] In postoperative patients, dexmedetomidine lowers cortisol and norepinephrine levels, as well as blood glucose, interleukin (IL)-6, tumour necrosis factor-a, and C-reactive protein, and raises interleukin-10. Moreover, because Dexmedetomidine does not affect upper airway reflexes, it is an excellent option.It was believed that the sedative impact of intravenous injection on newborn infants was very minimal and could be disregarded due to the delayed sedative effects |
| Tramadol | Experimental | Drug: TramadolTramadol, a centrally acting analgesic with -opioid agonist properties and little action on kappa and delta receptors, has been proven to be beneficial in preventing post-spinal shivering. The method of action is thought to be through a modulatory influence on central monoaminergic pathways, which inhibits noradrenaline and serotonin neuronal absorption in the spinal cord while boosting hydroxyltryptamine production, resetting the body temperature regulatory center. [3] However, it has many side effects, including nausea, vomiting, and dizziness, which add to the patient's pain. [5] Hence research into novel solutions with adequate safety and effectiveness is strongly advised. In this sense, despite taking into account the gold standard for post spinal shivering control is pethidine. it is contraindicated in breastfeeding which is both legally and ethically challenging for women. |
Who may qualify
- Ages
- 18 to 38 years
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (3 listed)
- Patient who will give consent
- ASA 2 patients
- Female gender of age 18 to 38
Key exclusion criteria (7 listed)
- Patient allergic to any drugs
- Uncontrolled HTN
- Antepartum
- Cardiomyopathy
- Peripartum haemorrhage
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Dexmedetomidine injectionDexmedetomidine intravenous | Drug | Dexmedetomidine |
| TramadolTramadol intravenous | Drug | Tramadol |
Primary outcome
Assessment of post spinal shivering by observing grades of shivering
Time frame: 10 minutes
Control of post spinal shivering Dexmedetomidine and tramadol for post spinal shivering
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Nov 2022.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Dexmedetomidine injection and Tramadol in people with Post Spinal Shivering, run by Sana Bahadur.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 15 Nov 2022. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Assessment of post spinal shivering by observing grades of shivering (time frame: 10 minutes). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Nov 2022.