Background and Aims:Cesarean sections are performed mostly under spinal anesthesia. Shivering is one of the distressing complications. The aim of the study was to compare the efficacy of intravenous (i.v) magnesium sulfate and tramadol with placebo (normal saline) on postspinal shivering in elective cesarean section when used as prophylaxis.Methods:One hundred and thirty-five pregnant women between 18 and 35 years age, belonging to the American Society of Anesthesiologists’ physical Status II, undergoing elective cesarean section under spinal anesthesia were enrolled into the study. Patients belonging to Group C (control group, n = 45) received isotonic saline 100 mL i.v, Group T (tramadol group, n = 45) received tramadol 0.5 mg/kg in 100 mL isotonic saline i.v, whereas those in Group M (magnesium sulfate group, n = 45) received magnesium sulfate 30 mg/kg in 100 mL isotonic saline i.v after administering spinal anesthesia. Incidence and grades of shivering were noted. Data were analyzed using one-way ANOVA test and Chi-square test.Results:The incidence of shivering in Group C, Group T, and Group M were 67.5%, 43.9%, and 39%, respectively. The incidence of shivering in Group M and Group T was significantly low when compared to Group C (P = 0.008; P = 0.026), whereas there was no statistically significant difference between Groups T and M (P = 0.654).Conclusion:Magnesium sulfate and tramadol significantly reduce the incidence of shivering compared to placebo when used as prophylaxis in pregnant women undergoing cesarean section under spinal anesthesia. Magnesium sulfate reduces the severity of the shivering.

Background: Spine surgery is associated with significant blood loss, often requiring blood transfusion. The objective of this double blind study was to evaluate the efficacy of tranexamic acid (TXA) on perioperative blood loss in patients undergoing thoracic spine fixation. Materials and Methods:Sixty adult patients were randomized into two groups of 30 each. Group I received a bolus of 15 mg/kg i.v. of TXA after induction followed by a maintenance infusion of 1 mg/kg/hr up to closure of skin and Group II received an equivalent volume of normal saline after induction followed by a maintenance infusion of saline up to closure of skin. Outcome measures included perioperative blood loss, amount of blood transfusion, postoperative haemoglobin and haematocrit levels. Results:The mean perioperative blood loss was less in the TXA group compared to the placebo group (p value<0.001). The PRBCs transfusion was lower in the TXA group compared to the placebo group but there was no statistically significant difference between the two groups. The postoperative haemoglobin level was lower in the control group as compared to TXA group (p value <0.05). Conclusion:TXA is effective in reducing peri-operative blood loss and blood transfusion.

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