Clinical Trials Logo

Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04938219
Other study ID # 2021-00866; qu20Buddeberg
Secondary ID
Status Recruiting
Phase N/A
First received
Last updated
Start date June 24, 2021
Est. completion date December 2025

Study information

Verified date April 2024
Source University Hospital, Basel, Switzerland
Contact Bigna Buddeberg, MD
Phone +41 61 328 6417
Email bigna.buddeberg@usb.ch
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Shivering is known to occur in around 40% of women as a side effect of neuraxial anaesthesia during caesarean section.Women undergoing caesarean section under neuraxial anaesthesia are randomised into either the treatment group or control group. Women in both groups are observed during caesarean section. This study is to test a non-pharmacological and non-invasive treatment with two groups, an intervention and a control group. In the intervention group, intraoperative shivering during caesarean section is treated by placing two surgical gloves filled with warm water into the women's hands. In the control group, women will be treated with the current standard of care, which does not include specific treatment of shivering.


Description:

Shivering is an involuntary, repetitive activity of skeletal muscles that often, but not exclusively, occurs as a thermoregulatory response to cold. It is associated with neuraxial anaesthesia and is therefore a commonly observed phenomenon during caesarean sections. The main cause for this is a sympathetic block of vasoconstriction in the legs, leading to cutaneous heat loss and lower core temperature. This is not always accompanied by a cold sensation, because the perceived skin temperature is increased. Out of all common side effects of neuraxial anaesthesia, shivering is perceived as the most uncomfortable and disruptive one. It can also interfere with monitoring of blood pressure, oxygen saturation and legibility of electrocardiograms. It increases the metabolic rate and oxygen consumption by up to 400%. Therefore, lactic acid and carbon dioxide production are significantly increased. Pregnant women have reduced cardiac and pulmonary reserves and may therefore have less capacity to adapt to the increased metabolic demands caused by shivering. The incidence of shivering during caesarean section at the University Hospital Basel was determined by a previous study to be 41.0%. Studies have been conducted about pharmacological treatment options for intraoperative shivering during caesarean section. However, pharmacological treatment in pregnant and breastfeeding women is best reduced to a minimum. This study is to test a non-pharmacological and non-invasive treatment with two groups, an intervention and a control group. In the intervention group, intraoperative shivering during caesarean section is treated by placing two surgical gloves filled with warm water into the women's hands. In the control group, women will be treated with the current standard of care, which does not include specific treatment of shivering. The warm water method has been used by doctors to reduce shivering, but the actual effects of it have never been scientifically proven. The gloves will be used as a treatment, not a prophylactic measure. Therefore, only the women who exhibit shivering during surgery will be treated.


Recruitment information / eligibility

Status Recruiting
Enrollment 200
Est. completion date December 2025
Est. primary completion date December 2025
Accepts healthy volunteers Accepts Healthy Volunteers
Gender Female
Age group 18 Years to 40 Years
Eligibility Inclusion Criteria: - Ability to give informed consent - Age older than 18 years and younger than 40 years. - Gestational age >36 weeks - Shivering during regional anaesthesia for caesarean section Exclusion Criteria: - Inability to give informed consent - Latex allergy - Receiving combined spinal epidural anaesthesia (CSEA) - Secondary spinal anaesthesia for caesarean section in patients with unsatisfactory epidural labour analgesia

Study Design


Related Conditions & MeSH terms


Intervention

Other:
Gloves filled with warm tap water
The intervention in the treatment group will consist of nonsterile gloves, filled with regular tap water at a comfortable warm temperature and sealed with a plastic clip. The temperature of the water will not be measured, the investigators will take a temperature that feels comfortable in their hands

Locations

Country Name City State
Switzerland Kantonsspital Baden AG, Department of Anaesthesiology Baden Aargau
Switzerland University Hospital Basel; Department of Anaesthesiology Basel

Sponsors (1)

Lead Sponsor Collaborator
University Hospital, Basel, Switzerland

Country where clinical trial is conducted

Switzerland, 

Outcome

Type Measure Description Time frame Safety issue
Primary Change in intensity of shivering measured on a 5-point scale Shivering is evaluated during caesarean section 5 minutes after intervention. Shivering is graded on a scale from 0 (No shivering) to 4 (Violent muscular activity that involves the entire upper body) .The score will be recorded before the intervention and at 2 and 5 minutes after initiation of the intervention, as well as after arrival at the recovery area. Score: 0 - No shivering.
- No visible muscle activity, but one or more of piloerection, peripheral vasoconstriction or peripheral cyanosis (other causes excluded).
- Muscular activity in only one muscle group.
- Moderate muscular activity in more than one muscle group, but not generalized shaking.
- Violent muscular activity that involves the entire upper body.
at baseline, at 2 and 5 minutes after the first assessment, and in the post-anaesthesia recovery room (approx.1 hour)ent.
Secondary Change in subjective comfort levels of the patients before and after the intervention on a 11-point scale Change in subjective comfort level of the participant before and after the intervention on a 11-point scale (0 being very uncomfortable; 10 being very comfortable). The patient will be asked to rate their comfort level every time a shivering score is obtained. at baseline, at 2 and 5 minutes after the first assessment, and in the post-anaesthesia recovery room (approx.1 hour)
See also
  Status Clinical Trial Phase
Recruiting NCT04730609 - Dexmedetomidine for Intraoperative Shivering in Scheduled Elective Cesarean Delivery Phase 4
Completed NCT02141412 - Intravenous Dexmedetomidine For The Quaity Of Emergence From General Anesthesia Phase 4
Not yet recruiting NCT06283771 - The Effect of Heated Socks Developed With Wearable Technology on Hypothermia, Thermal Comfort Perception and Shivering N/A
Completed NCT02436174 - Assessment Of Shivering With iSeismograph N/A
Completed NCT03302351 - Dexmedetomidine, Ketamine and Dexmetedomidine-Ketamine Combination for Control of Shivering During Regional Anaethesia Phase 4
Completed NCT03721432 - The Effect of Oral Pregabalin on Epidural-induced Shivering and Epidural Characteristics N/A
Not yet recruiting NCT03530007 - Anti-shivering Effect of Ondansetron Phase 2/Phase 3
Completed NCT03679065 - Prophylactic Paracetamol or Dexamethasone for Post-spinal Anesthesia Shivering Phase 4
Completed NCT03679052 - Prophylactic Mirtazapine or Clonidine for Post-spinal Anesthesia Shivering Phase 4
Completed NCT03675555 - Prophylactic Mirtazapine or Dexamethasone for Post-spinal Anesthesia Shivering Phase 4
Active, not recruiting NCT05284409 - Comparative Study Between the Prophylactic Intravenous Administrations of Acetaminophen vs Dexamethasone vs Pethidine Regarding the Incidence of Shivering Induced by Single Shot Spinal Anesthesia in the Orthopedic Surgeries of the Lower Limbs Phase 4
Recruiting NCT03157648 - Relationship Between Core-peripheral Temperature Difference and Shivering Symptom in Patients in PACU N/A
Terminated NCT03497507 - Investigating the Effect of Acupressure on Shivering During a Cesarean Delivery in Women Who Were Previously Laboring With an Epidural N/A
Completed NCT03370562 - Dexmedetomidine After Cesarean for the Treatment of Nausea and Shivering N/A
Completed NCT05110469 - Comparison of MgSO4 Versus Meperidine for Prevention of Shivering During Spinal Anesthesia Phase 4
Not yet recruiting NCT03566628 - Post-anaesthetic Shivering Amongst Patients Undergoing Cerebral Angiography N/A
Completed NCT02967601 - Influence of Preoperative Anxiety on Shivering During Elective Caesarean Section Under Spinal Anaesthesia N/A
Recruiting NCT05765162 - Safe Brain Initiative, Operationalizing Precision Anaesthesia
Recruiting NCT04870541 - Nefopam Versus Ondansteron for Prevention of Post Spinal Shivering. Phase 4
Active, not recruiting NCT01669213 - Effects of Different Kinds, Different Doses of 5-HT3 Receptor Antagonists on Prevention of Hypotension N/A

External Links