Comparison of the Effects of Intrathecal Midazolam and Tramadol with the Conventional Method of Postoperative Pain and Shivering Control after Elective Cesarean Section

Pazuki, Shirin; Kamali, Alireza; Nasim, Shahrokhi; Jamilian, Mehri

doi:10.13005/bpj/1039

Cited by 11 publications

(8 citation statements)

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“…Also, our findings are in agreement with a study done by Pazuki et al (28) , who found that intrathecal midazolam is more effective than placebo in prevention of shivering. Honarmand and his coworkers (29) evaluated hundred and twenty patients scheduled for orthopedic surgery for post-spinal shivering after administration of intravenous ketamine, midazolam or combination of both drugs.…”

Section: Discussionsupporting

confidence: 94%

Nalbuphine Vs Midazolam for Prevention of Shivering in Patients Undergoing Lower Limb Surgery under Spinal Anesthesia; Prospective, Randomized and Double Blinded Controlled Study

Mohamed

Ali

Badawy

2021

The Egyptian Journal of Hospital Medicine

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Background: Shivering is an involuntary, repetitive contractions of skeletal muscles, which commonly occurred after spinal block and it is an uncomfortable problem to the patients and the anesthetists. Shivering is considered as a complication of anesthesia. Shivering has deleterious effects on the cardiac function especially in patients who have limited cardiopulmonary reserve and coronary disease, which could be explained by increased oxygen consumption, production of carbon dioxide and lactic acidosis caused by shivering. Objective: Our study was aiming at evaluating the effect of intrathecal nalbuphine versus intrathecal midazolam in the prevention of shivering during subarachnoid block. Patients and Methods: Ninety patients (ASA physical status I or II) scheduled for lower limb surgeries under spinal anesthesia were randomly allocated into three groups using sealed envelopes technique; Control group receiving mixture of bupivacaine and saline, Nalbuphine (N) group receiving nalbuphine and bupivacaine, and Midazolam group receiving midazolam and bupivacaine. Upon arrival to the operation room basic monitoring was applied and lactated ringer solution at room temperature was infused through peripheral venous catheter. Results: Shivering occurred in 20 patients (66.7%) in control group, 7 patients in nalbuphine group (23.3%), and 10 in midazolam group (33.3%). The incidence of shivering and core temperature differed significantly between group N and the other two groups (P values in saline and midazolam groups > 0.05, while that of nalbuphine < 0.05). Conclusion: Intrathecal nalbuphine is more effective than intrathecal midazolam in prevention of post-spinal shivering for patients undergoing lower limb surgery.

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Section: Discussionsupporting

confidence: 94%

Nalbuphine Vs Midazolam for Prevention of Shivering in Patients Undergoing Lower Limb Surgery under Spinal Anesthesia; Prospective, Randomized and Double Blinded Controlled Study

Mohamed

Ali

Badawy

2021

The Egyptian Journal of Hospital Medicine

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“… 25 In another study by Kamali et al (2010) 26 in children of 2 to 8 year old, undergoing lower abdominal surgery, it was showed that the addition of neostigmine and midazolam to bupivacaine 0.25% in caudal anesthesia method, led to an increase in the duration of analgesia in children and improved quality of the block, while the duration of analgesia in the neostigmine group was more than in the midazolam group. In another study by Kamali et al (2015) 27 on patients undergoing cesarean section, the effects of adding midazolam and tramadol to lidocaine 5% was compared. In this study it was found that the addition of both adjuvants (tramadol and midazolam) led to an increase in the duration of analgesia and improve quality of block, also pain score in patients and the drugs used in these patients within 24 hours after surgery in tramadol group was lower than midazolam group.…”

Section: Resultsmentioning

confidence: 99%

Addition of Neostigmine and Tramadol to 1.5 % Lidocaine for paracervical block to reduce post-operative pain in colporrhaphy

et al. 2018

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Pain is a complex and multi-faceted human perception and several factors could dampen the pain. Therefore, we aimed to comparison of addition of neostigmine and tramadol to 1.5 % lidocaine with paracervical block in reduce of post-operative pain in colporrhaphy. This study was a randomized and double-blind clinical trial for 108 patients’ as candidate for colporrhaphy. Patients were randomly divided in three groups (Neostigmine, tramadol and control).We recorded pain in 2 and 6 and 12 hours after surgery, duration of analgesia and mean of use narcotic drug in 24 hours after surgery for all patients. Mean of narcotic drug used in 24 hours after surgery in neostigmine group was more than tramadol group(p=0/01).Pain in 2 and 6 and 12 hours after surgery in neostigmine group was more than tramadol group (p=0/01). Duration of analgesia in tramadol group was over neostigmine group and also, it was in neostigmine group was more than placebo (p=0/01).Taken together, tramadol could reduce pain in 2 and 6 and 12 hours after surgery and mean of narcotic drug used in 24 hours after surgery and increase duration of analgesia.

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“…Various previous studies have pointed to the positive prophylactic effects of dexamethasone and ondansetron on post-spinal anesthesia headache and they could reduce the rate of this headache (2,3,4,(15)(16)(17)(18)(19). Some papers have pointed to dexamethasone's therapeutic effects in controlling headaches caused by spinal anesthesia (4,6,(20)(21)(22)(23)(24)(25). In a research by Zainabosadat Fattahi et al (2015) on 210 elective caesarean patients in Iran who had undergone spinal anesthesia, ondansetron was shown to play a major role in relieving headaches caused by spinal anesthesia (2) which is in line with the results of our research.…”

Section: Discussionmentioning

confidence: 99%

Comparing the prophylactic effect of ondansetron and dexamethasone in controlling headaches caused by spinal anesthesia among women candidated for caesarean A randomized controlled trial

et al. 2018

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Introduction:Spinal anesthesia is one of the most popular methods of anesthesia for caesarean. One of the major side effects of this method is the headache that the patients would experience as a result of spinal anesthesia. Ondansetron and dexamethasone have been reported to be very useful in reducing these headaches. The present research seeks to study the effects of these two types of medicine in reducing the headaches caused by spinal anesthesia among women candidated for caesarean. Materials and Methods: This is a double-blind clinical trial conducted on 120 mothers candidated for elective, second time caesarean. They were divided into the following groups with 40 participants in each one: dexamethasone, ondansetron, and placebo. 8 milligram of IV dexamethasone was used for the first group, while the second group was given 8 milligram of IV ondansetron, and the third group was given the same amount of IV distilled water. After the operation, patients' pain scores were measured at 12, 24, and 48 hours following the operation and the average amount of painkiller used 24 hours after the operation was recorded. SPSS 19 was used to analyze the data. Results: A significant difference was observed between the three groups in terms of the frequency of post-spinal anesthesia headache. This frequency was significantly higher in placebo group compared to what was observed in the other two groups (P = 0.01). Conclusion: Finally, it turned out that both dexamethasone and ondansetron are very effective in reducing headaches caused by spinal anesthesia. Statistics show that dexamethasone is much better and more effective than ondansetron.

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Comparison of the Effects of Intrathecal Midazolam and Tramadol with the Conventional Method of Postoperative Pain and Shivering Control after Elective Cesarean Section

Cited by 11 publications

References 0 publications

Nalbuphine Vs Midazolam for Prevention of Shivering in Patients Undergoing Lower Limb Surgery under Spinal Anesthesia; Prospective, Randomized and Double Blinded Controlled Study

Nalbuphine Vs Midazolam for Prevention of Shivering in Patients Undergoing Lower Limb Surgery under Spinal Anesthesia; Prospective, Randomized and Double Blinded Controlled Study

Addition of Neostigmine and Tramadol to 1.5 % Lidocaine for paracervical block to reduce post-operative pain in colporrhaphy

Comparing the prophylactic effect of ondansetron and dexamethasone in controlling headaches caused by spinal anesthesia among women candidated for caesarean A randomized controlled trial

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