Hans P. Sviggum, M.D.

Closed for Enrollment

• Dexmedetomidine for Treatment of Shivering During Cesarean Delivery: Determining the Optimal Dose Rochester, Minn.

  The purpose of this study is to determine the optimum dose of Dexmedetoidine to stop shivering in 90% of patients who experience shivering during cesarean delivery. We will be using an up-down sequential allocation method with biased-coin design to determine the ED90 of dexmedetomidine for effectively treating shivering during CD.

  Perioperative shivering is a commonly observed intraoperative problem during cesarean delivery (CD). The median incidence of shivering in women undergoing CD or having labor epidural analgesia has been estimated to be over 50%. Shivering can create a number of problems including: increased physiologic stress, interference with patient monitors (e.g., blood pressure recording), and decreased patient satisfaction.

   

   

• Intrathecal Morphine Versus Intrathecal Hydromorphone for Analgesia Following Cesarean Delivery Rochester, Minn.

  Intrathecal (IT) opioids are commonly administered with local anesthetic during spinal anesthesia for post-Cesarean delivery analgesia. Traditionally, IT morphine has been used but the use of IT hydromorphone is growing. Our group recently found the effective dose for postoperative analgesia in 90% patients (ED90) for both IT hydromorphone and IT morphine (IRB # 13-008490). These doses that we found were 75 mcg for hydromorphone and 150 mcg for morphine. Our current proposed study would compare the duration of analgesia of IT morphine vs IT hydromorphone after elective cesarean delivery. Additionally, we will compare each drug on the incidence of nausea and pruritus.

• Intrathecal Opioids for Pain Control after Cesarean Delivery: Determining the Optimal Dose Rochester, Minn.

  Both hydromorphone and morphine are administered as part of spinal anesthesia to help improve pain control after cesarean delivery. In this study, the investigators are going to determine the doses of each of those medicines that provides optimal pain control to women undergoing cesarean delivery while limiting side effects related to those medicines. The investigators hypothesize that the doses of hydromorphone and morphine that provide optimal pain control without significant side effects will be 100 micrograms and 150 micrograms, respectively. The investigators further hypothesize that at each respective optimal dose, side effects will be less in the hydromorphone group.