A comparative study on the efficacy of dexmedetomidine and tramadol on post-spinal anesthesia shivering

Kundra, Tanveer Singh; Kuthiala, Gaurav; Shrivastava, Anurag; Kaur, Parminder

doi:10.4103/1658-354x.197344

Cited by 23 publications

(31 citation statements)

References 7 publications

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“…In our study Tramadol is given in dose of 0.5mg/kg based on previous studies that used tramadol in a dose of 0.5mg/kg Table-5 and was found safe and effective for control of shivering. [12][13][14][15] Ondansetron is given in a dose of 8mg was selected based on the study by Mahoori et. al, 16 in year 2014 where they concluded that ondansetron and Pethidine have similar effects on shivering and that 8 mg of intravenous ondansetron can control shivering and is the dose of choice.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Intravenous Ondansetron and Tramadol for Control of Shivering during Spinal Anaesthesia: A Prospective, Observer Blind Study

Chowdhury¹,

Lohar²,

Ray³

et al. 2018

IJCMR

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Introduction: Post spinal shivering is a frequent problem in parturient undergoing lower segment caesarean section. We conducted a study in parturient undergoing lower segment caesarean section, to compare the efficacy of Ondansetron and Tramadol for control of shivering under regional anaesthesia. Material and Methods: A randomised prospective double blinded single hospital comparative study was conducted Gauhati Medical College and Hospital, Guwahati, Assam, from a period of August 2016 to July 2017. 124 ASA I and II patients planned for lower segment caesarean section were randomly classified into two groups A and B, Group A received 0.5mg/kg tramadol and Group B received 8mg bolus ondansetron. Result: The complete disappearance of shivering took a mean of 3.4 minutes in Group A while 5.1 minutes in Group B (p value ≤0.05). Conclusion: I.V Tramadol is superior to ondansetron for control of shivering with early onset.

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Section: Discussionmentioning

confidence: 99%

Comparison of Intravenous Ondansetron and Tramadol for Control of Shivering during Spinal Anaesthesia: A Prospective, Observer Blind Study

Chowdhury¹,

Lohar²,

Ray³

et al. 2018

IJCMR

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“…Different drugs that act on these receptors have been examined in different trials for the prevention or treatment of shivering after SA(4). The studied drugs include meperidine, fentanyl, clonidine, ketamine, and tramadol; they have resulted in different degrees of efficacy and many associated side effects, such as haemodynamic instability, respiratory depression, nausea and vomiting(27).Dexmedetomidine(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) and magnesium sulfate(2,3,(17)(18)(19)(20) have been demonstrated to be effective and safe for the prevention and treatment of shivering following SA; their efficacy and safety are equal or superior to other adjuvants, with fewer adverse effects. Few trials(3,5,15,17) have examined intrathecal administration to prevent SA-related shivering.…”

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confidence: 99%

Comparative study between intrathecal dexmedetomidine and intrathecal magnesium sulfate for the prevention of post-spinal anaesthesia shivering in uroscopic surgery. (RCT)

Omar

adel

Hassan

et al. 2019

Preprint

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Background: Hypothermia and shivering are common complications after spinal anaesthesia, especially after uroscopic procedures in which large amounts of cold intraluminal irrigation fluids are used. Magnesium sulfate and dexmedetomidine are the most effective adjuvants with the least side effects. The aim of this study was to compare the effects of intrathecal dexmedetomidine versus intrathecal magnesium sulfate on the prevention of post-spinal anaesthesia shivering. Methods: This prospective randomized, double-blinded controlled study included 105 patients who were scheduled for uroscopic surgery at the Kasr El-Aini Hospital. The patients were randomly allocated into three groups. Group C (n=35) received 2.5 ml of hyperbaric bupivacaine 0.5% (12.5 mg) + 0.5 ml of normal saline, Group M (n=35) received 2.5 ml of hyperbaric bupivacaine 0.5% (12.5 mg) + 25 mg of magnesium sulfate in 0.5 ml saline, and Group D (n=35) received 2.5 ml of hyperbaric bupivacaine 0.5% (12.5 mg) + 5 μg of dexmedetomidine in 0.5 ml saline. The primary outcomes were the incidence and intensity of shivering. The secondary outcomes were the incidence of hypothermia, sedation, the use of meperidine to control shivering and complications. Results: Group C had significantly higher proportions of patients who developed shivering (21), developed grade IV shivering (20) and required meperidine (21) to treat shivering than group M (8,5,5) and group D (5,3,6) , which were comparable to each other. The time between block administration and meperidine administration was similar among the three groups. Hypothermia did not occur in any of the patients. The three groups were comparable regarding the occurrence of nausea, vomiting, bradycardia and hypotension. All the patients in group C, 32 patients in group M and 33 patients in group D had a sedation score of 2. Three patients in group M and 2 patients in group D had a sedation score of 3. Conclusions: Intrathecal injections of both dexmedetomidine and magnesium sulfate were effective in reducing the incidence of post -spinal anaesthesia shivering. Therefore, we encourage the use of magnesium sulfate, as it is more physiologically available, more readily available in most operating theatres and much less expensive than dexmedetomidine.

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“…[ 8 ] Different pharmacological agents studied for their potential in prevention of peri- or post-operative shivering include clonidine, tramadol, dexmedetomidine, ondansetron, granisetron, ketamine, and pethidine. [ 2 3 10 11 12 13 14 ]…”

Section: Introductionmentioning

confidence: 99%

“…[ 17 18 ] Clonidine, a α 2 receptor agonist is effective in reducing the incidence of shivering and decrease oxygen consumption during recovery from anesthesia Kundra et al . [ 10 ] The anti-shivering effect of clonidine is because of the actions at three levels; hypothalamus, locus coeruleus, and spinal cord. The postulated mechanisms include alteration of thermoregulatory threshold for vasoconstriction, activation of α 2 receptors at the spinal cord level and release of norepinephrine and other mediators.…”

Section: Introductionmentioning

confidence: 99%

Comparative efficacy and safety of intravenous clonidine and tramadol for control of postspinal anesthesia shivering

2018

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Background:Shivering is a common problem in patients undergoing surgery under spinal anesthesia.Aims:The aim of this study was to compare efficacy and safety of clonidine versus tramadol in postspinal anesthesia shivering.Settings and Design:This prospective, randomized, double-blind controlled clinical trial was conducted in a tertiary care setting.Materials and Methods:A total of 60 American Society of Anesthesiologists physical status Class l and II adult patients (age 18–65 years) undergoing surgery under spinal anesthesia and developed shivering received either clonidine 1 μg/kg or tramadol 1 mg/kg intravenously. The time required for cessation of shivering, control and recurrence rate of shivering, effect on hemodynamics and side effects were compared between two groups.Statistical Analysis:Unpaired t-test and Chi-square test were used for comparison of continuous variables and dichotomous data between two groups, respectively. P < 0.05 was considered as statistically significant.Results:Time for cessation of shivering was less in clonidine group than tramadol group (02.51 vs. 04.82 min; P < 0.001). Complete control of shivering was achieved in 80% of patients in clonidine group versus 70% in tramadol group. There was no significant difference for control (P = 0.5) and rate of recurrence of shivering between clonidine and tramadol group (06.7% vs. 16.7%; P = 0.42). Pulse rate and systolic blood pressure were significantly lower in clonidine group at 5 and 15 min as compared with tramadol. Significantly more number of patients experienced nausea and dizziness (36.7% vs. 0%; P < 0.001 and 20% vs. 0%; P = 0.01) with tramadol while bradycardia and hypotension were numerically more common in patients receiving clonidine (6.7% vs. 0% and 13.3% vs. 0%).Conclusion:Clonidine provides early relief from shivering than tramadol with fewer side effects in patients undergoing surgery under spinal anesthesia.

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A comparative study on the efficacy of dexmedetomidine and tramadol on post-spinal anesthesia shivering

Cited by 23 publications

References 7 publications

Comparison of Intravenous Ondansetron and Tramadol for Control of Shivering during Spinal Anaesthesia: A Prospective, Observer Blind Study

Comparison of Intravenous Ondansetron and Tramadol for Control of Shivering during Spinal Anaesthesia: A Prospective, Observer Blind Study

Comparative study between intrathecal dexmedetomidine and intrathecal magnesium sulfate for the prevention of post-spinal anaesthesia shivering in uroscopic surgery. (RCT)

Comparative efficacy and safety of intravenous clonidine and tramadol for control of postspinal anesthesia shivering

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