Title: Efficacy and Safety of Tramadol and Dexmedetomidine in Treatment of Shivering Following Spinal Anaesthesia: A Randomized Controlled Study
Authors: Akshita Singla, Madhavi Chaudhari, Alpa Patel
DOI: https://dx.doi.org/10.18535/jmscr/v5i4.98
Abstract
Context: Shivering occurs in approximately 50% of cases after administration of spinal anaesthesia. Post spinal shivering is distressing to the patient. Pharmacological agents are method of choice for control of post-spinal shivering.
Aim and Objectives: To determine effectiveness of tramadol and dexmedetomidine in control of post spinal shivering and comparison of their side effects.
Materials and Methods: Hundred patients, ASA I and II, aged between16-65 years were grouped in two groups, group T(tramadol) and group D(dexmedetomidine) according to computer generated randomised control table. Shivering scores were calculated at 0, 5, 10, 15, 30, 90 & 120 mins after spinal anaesthesia. Patients in group T received Inj Tramadol 0.5mg/kg and group D Inj Dexmedetomidine 0.5µg/kg in 100 ml of normal saline (NS) over 10 mins intravenously (IV) after development of grade 2 shivering. Postoperative nausea vomiting (PONV) and sedation scores were calculated. Incidence of side effects i.e. bradycardia, hypotension and respiratory depression were also studied.
Statistical Analysis Used: Continuous data was analysed using independent 't' test and categorical data was analysed using Chi-square test.
Results: There were 50 patients in each group. Additional measures for control of shivering was required in 2 patients in group T and none in group D. Mean time for control of shivering in group T was 14.08±11.83 mins vs. group D 8.74±5.54mins (p=0.002). Sedation was higher in group D (p <0.001) but PONV was seen in group T only (p <0.001).
Conclusion: Dexmedetomidine is a better agent for control of post spinal shivering.
Key words: Post spinal shivering, tramadol, dexmedetomidine
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