Premedication with oral tramadol reduces severity of postoperative shivering after general anesthesia

Heidari, Sayed Morteza; Rahimi, Mojtaba; Soltani, Hassanali; Hashemi, Seyed Jalal; Shabahang, Shadi

doi:10.4103/2277-9175.125845

Cited by 7 publications

(6 citation statements)

References 13 publications

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“…Our trial showed that oral tramadol was effective in reducing the incidence, frequency, duration and severity of post-spinal shivering and meperidine consumption. In agreement with our results, tramadol was reported to be effective in decreasing the incidence and severity of shivering after spinal or general anaesthesia [ 5 , 25 – 27 ]. Our study results showed that the efficacy of anti-shivering medications greatly varies between its prophylactic and therapeutic uses.…”

Section: Discussionsupporting

confidence: 92%

Effects of oral premedication with tramadol, pregabalin or clonidine on shivering after spinal anaesthesia in patients undergoing hysteroscopic procedures

Gaballah¹,

Abdallah²

2020

ait

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Shivering is a common unpleasant perioperative complication of neuraxial anaesthesia. It has been reported in 40-70% of regionally anaesthetized patients. Shivering is a physiological compensatory response to core hypothermia due to redistribution of heat as a result of vasodilatation from chemical sympathectomy of spinal anaesthesia, exposure to a cool environment, infusion of unwarmed fluids and evaporation from exposed surfaces [1]. During neuraxial anaesthesia, not only is core heat redistributed from the trunk (below the sympathectomy level) to the periphery, but also the thermoregulatory system is significantly impaired due to the inhibited tonic vasoconstriction [2]. Moreover, the shivering threshold is reduced by about 0.5°C during neuraxial anaesthesia [3]. The exposure of the thermosensitive structures within the spinal cord to a cold local anaesthetic is another contributing factor [4].

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Section: Discussionsupporting

confidence: 92%

Effects of oral premedication with tramadol, pregabalin or clonidine on shivering after spinal anaesthesia in patients undergoing hysteroscopic procedures

Gaballah¹,

Abdallah²

2020

ait

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“…The type of surgery and sex difference of the patients can justify this inconsistency. [ 25 ] It seems that the use of alpha-2 agonists to prevent and reduce shivering in patients underwent spinal anesthesia is reasonable and appropriate. These drugs can have a sedative effect on the patients during surgery which lead to reduce anxiety.…”

Section: Discussionmentioning

confidence: 99%

Comparison the Effects of Oral Tizanidine and Tramadol on Intra- and Post-operative Shivering in Patients Underwent Spinal Anesthesia

et al. 2018

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Background:Heat loss and core-to-peripheral redistribution of body heat occur in patients undergoing neuraxial anesthesia resulted to decrease of core temperature and early reach of shivering threshold. Because shivering has deleterious metabolic and cardiovascular effects, it should ideally be prevented by pharmacologic or other means. Tizanidine is an alpha-2 agonist. We evaluated the usefulness of oral tizanidine (TI) and tramadol in preventing of shivering in patients undergoing spinal anesthesia for transurethral resection of the prostate (TURP).Materials and Methods:Ninety patients, scheduled for TURP with spinal anesthesia, were prospectively enrolled. Patients were randomly assigned to 1 of 3 groups. 90 min before spinal anesthesia, 30 patients received 4 mg oral TI, 30 patients received 50 mg tramadol, and 30 patients received placebo as control group. Spinal anesthesia was induced at the L3–L4 or L4–L5 interspaces with 12.5 mg bupivacaine. An investigator blinded to the drugs recorded the frequency and degree of shivering.Results:The overall frequency and severity of shivering were significantly lower in patients treated with TI and tramadol compared to placebo (P = 0.04) (P = 0.001). There was not much difference in the nausea and vomiting of both the drugs (P = 026) (P = 011). There was no difference in hemodynamic parameters between three groups (P = 0.08) (P = 013).Conclusions:Oral TI and tramadol were comparable in respect to their effect in decreasing the incidence, intensity shivering when used prophylactically in patients who underwent TURP with spinal anesthesia.

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“…Mohta et al also reported that tramadol 2 mg/kg provided an effective combination of anti-PAS activity and analgesia without excessive sedation [ 8 ]. Moreover, Heidari et al found that premedication with oral tramadol reduced the severity of PAS [ 9 ]. In preliminary study, we also originally administered tramadol 2 mg/kg, but PAS still occasionally occurred.…”

Section: Discussionmentioning

confidence: 99%

The effects of tramadol on postoperative shivering after sevoflurane and remifentanil anesthesia

Nagao

Hashimoto

et al. 2017

BMC Anesthesiol

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BackgroundsRemifentanil has been reported to cause post-anesthetic shivering (PAS). Higher doses of remifentanil reportedly induce more intense PAS. Tramadol, a synthetic opioid that acts at multiple sites, is considered to be an effective treatment for PAS, but the evidence for its therapeutic benefit after remifentanil anesthesia is limited. We investigated the effect of tramadol on the incidence of PAS after remifentanil anesthesia.MethodsSixty-three patients who had undergone upper abdominal surgery under general anesthesia were studied retrospectively. Tramadol was administered at induction of anesthesia. The patients were divided into four groups: HT(+), high dose remifentanil (1–1.5 μg/kg/min) with tramadol; HT(−), high dose remifentanil without tramadol; LT(+), low dose remifentanil (0.15–0.25 μg/kg/min) with tramadol; and LT(−), low dose remifentanil without tramadol. We recorded perioperative changes in nasopharyngeal temperature and episodes of PAS on emergence from anesthesia.ResultsThe incidences of PAS in both tramadol treatment groups were significantly lower than the groups that did not receive tramadol. Nasopharyngeal temperature after surgery fell significantly more from baseline in the tramadol treatment groups compared with the non-treatment groups.ConclusionTramadol administered at induction of anesthesia appears to suppress PAS following remifentanil anesthesia.

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Premedication with oral tramadol reduces severity of postoperative shivering after general anesthesia

Cited by 7 publications

References 13 publications

Effects of oral premedication with tramadol, pregabalin or clonidine on shivering after spinal anaesthesia in patients undergoing hysteroscopic procedures

Effects of oral premedication with tramadol, pregabalin or clonidine on shivering after spinal anaesthesia in patients undergoing hysteroscopic procedures

Comparison the Effects of Oral Tizanidine and Tramadol on Intra- and Post-operative Shivering in Patients Underwent Spinal Anesthesia

The effects of tramadol on postoperative shivering after sevoflurane and remifentanil anesthesia

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