Estudo prospectivo randômico, duplo‐cego e controlado comparando tramadol, clonidina e dexmedetomidina para tremores pós‐raquianestesia

Venkatraman, Rajagopalan; Karthik, Krishnamoorthy; Pushparani, Anand; Mahalakshmi, Annadurai

doi:10.1016/j.bjan.2017.04.019

Cited by 9 publications

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“…The former acts by reducing the central thermosensitivity and release of noradrenaline from axonal terminals in the hypothalamus whereas later reduces uptake of neuronal uptake of noradrenaline and (5-HT). [ 3 ] Tramadol acts at the level of pons. It reduces the uptake of 5-HT, a major neurotransmitter in the raphe nucleus, which plays an important role in the modulation of pain.…”

Section: Discussionmentioning

confidence: 99%

“…In another recent study, the same dose of clonidine was used by Venkatraman et al . [ 3 ] Tramadol in the dose of 1 mg/kg has been shown to be effective for prevention of postoperative shivering. [ 24 ] Dose of clonidine as well as tramadol in our study is similar to another study.…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 ] It is an important concern in patients undergoing surgery under general anesthesia[ 2 ] as well as regional anesthesia, i.e. spinal anesthesia[ 3 ] or epidural anesthesia. [ 4 ] The reported median incidence of shivering related to neuraxial anesthesia from different studies is 55%.…”

Section: Introductionmentioning

confidence: 99%

“…Because of its associated discomfort,[ 2 3 ] distress,[ 3 ] aggravation of pain, increased metabolic demands, and increased oxygen consumption[ 9 ] prevention and treatment of postanesthesia shivering is an important component of perioperative management of the patient. [ 2 ] Nonpharmacological as well as pharmacological measures are useful in prevention of hypothermia and shivering.…”

Section: Introductionmentioning

confidence: 99%

“…[ 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%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

2018

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Effect of intravenous tramadol versus pethidine on postspinal shivering control among mothers during cesarean section at Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia: a prospective observational cohort study

Mamo

Zema

Abera

et al. 2023

Annals of Medicine &Amp; Surgery

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Background: Postspinal anesthesia shivering is a common complication during spinal anesthesia. It is very unpleasant and physiologically stressful for patients and challenging for healthcare providers. Shivering could be treated with tramadol or pethidine. However, the comparative effectiveness of one drug over the other drug has not been proven with a low-drug setup. Objective: To compare the effect of intravenous tramadol versus pethidine on postspinal shivering control among obstetric mothers who underwent cesarean section. Methods and materials: A prospective cohort study design was conducted on 180 ASA (American Society of Anesthesiology) I and II obstetric mothers. A systematic random sampling method was employed. Data were entered into EpiData version 4.6 and exported into SPSS version 25 for analysis. The independent sample t test was used to compare the difference of means between groups for normally distributed data, and the Mann–Whitney U test was used for non-normally distributed data. Categorical data were analyzed using the chi-squared test. Data were presented by mean±standard deviation for normally distributed data and median and interquartile range for non-normally distributed data. Categorical data were presented as numbers and frequencies. P values less than 0.05 were considered statistically significant. Results: One hundred eighty participants were used for analysis. The mean time of shivering disappearance was 5.5±1.75 min and 6.6±2.08 min in tramadol and pethidine groups, respectively (P<0.001). The hemodynamic changes were all comparable between the two groups. The difference in the recurrence of shivering after treatment was significant between the groups (P<0.001). Sedation was higher in the pethidine group, 9 (10%), than in the tramadol group, 2 (2.2%). Nausea and vomiting were found to be higher in the tramadol group, 10 (11.1%), than in the pethidine group, 5 (5.6%). Conclusions: Tramadol controlled shivering early, and recurrence of shivering and incidence of sedation were also low in the tramadol group. Therefore, tramadol is as effective as pethidine for the treatment of postspinal shivering in obstetric mothers who underwent cesarean delivery. So tramadol can be used as an alternative for postspinal shivering in obstetric mothers.

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Intravenous dexmedetomidine versus intravenous clonidine for post spinal anesthesia shivering: a meta-analysis of randomized controlled trials

Wang

Song

et al. 2020

Scott Med J

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Background Dexmedetomidine and clonidine are the most extensively studied drugs for shivering treatment, because α2-adrenergic agonists can reduce the shivering threshold. The objective of this meta-analysis was to compare the efficacy and complications of dexmedetomidine with those of clonidine, when used for control of post spinal anesthesia shivering. Methods Electronic databases were searched for randomized controlled trials (RCT) comparing the effect of dexmedetomidine versus clonidine for control of post spinal anesthesia shivering. The endpoints were effective rate of shivering treatment, time to cease shivering, recurrent rate of shivering and complications. Results Six studies comprising 340 adult patients were included in this meta-analysis. Dexmedetomidine had higher effective rate of shivering treatment (odds ratio [OR]: 4.11, 95% confidence interval (CI): [1.53, 11.07], P = 0.005), shorter time to cease shivering (Mean differences (MD)=–1.91; 95% CI [–3.66, –0.15], P = 0.03), lower recurrent rate of shivering (OR = 0.30; 95% CI [0.12, 0.75], P = 0.01), compared to clonidine. Dexmedetomidine had a lower rate of hypotension and higher incidence of sedation than clonidine. Conclusions Dexmedetomidine is superior to clonidine when used for shivering treatment after spinal anesthesia, because of higher incidence of effective rate and sedation, faster control of shivering, lower incidence of recurrent rate and hypotention.

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Estudo prospectivo randômico, duplo‐cego e controlado comparando tramadol, clonidina e dexmedetomidina para tremores pós‐raquianestesia

Abstract: Dexmedetomidine is better than tramadol and clonidine in the control of shivering because of its faster onset and less recurrence rate. Though complications are encountered in the dexmedetomidine group, they are treatable.

Cited by 9 publications

References 19 publications

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

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

Effect of intravenous tramadol versus pethidine on postspinal shivering control among mothers during cesarean section at Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia: a prospective observational cohort study

Intravenous dexmedetomidine versus intravenous clonidine for post spinal anesthesia shivering: a meta-analysis of randomized controlled trials

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