Randomized double-blinded comparative study of intravenous nalbuphine and tramadol for the treatment of postspinal anesthesia shivering

Nirala, Deepak Kumar; Prakash, Jay; Ram, Barun; Kumar, Vishwanath; Bhattacharya, Pradip; Priye, Shio

doi:10.4103/aer.aer_95_20

Cited by 5 publications

(2 citation statements)

References 22 publications

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“…The modified Ramsay Sedation Score was used to determine the patient’s sedation score [ 8 ]. Additionally, blood pressure, pulse, peripheral oxygen saturation (SpO 2 ), and postoperative nausea and vomiting were also noted.…”

Section: Methodsmentioning

confidence: 99%

The Comparison of Dexmedetomidine to Dexamethasone as Adjuvants to Bupivacaine in Ultrasound-Guided Infraclavicular Brachial Plexus Block in Upper Limb Surgeries

Iyengar¹,

Pangotra²,

Kumar³

et al. 2023

Cureus

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Background The clinical utility of adjuvants with local anesthesia produces an excellent nerve block with prolonged duration and faster onset. Brachial plexus block is widely used nowadays in patients undergoing upper limb surgery There are several approaches to achieve brachial plexus block such as interscalene, supraclavicular, infraclavicular, and axillary. The objective of this study is to compare the effectiveness of dexamethasone to dexmedetomidine as adjuvants to bupivacaine in patients undergoing ultrasound-guided infraclavicular brachial plexus (USG-ICBP) block. Methods A randomized, prospective, double-blind study was undertaken on the patients posted for upper limb surgeries under ultrasound-guided infraclavicular brachial plexus block. Sixty patients with the American Society of Anesthesiologists (ASA) classes I and II were randomly allocated into two groups. Group A received 25 mL of 0.5% bupivacaine and 1.5 mL (6 mg) of dexamethasone, and group B received 25 mL of 0.5% bupivacaine and 0.75 mL (75 mcg) of dexmedetomidine along with 0.75 mL of 0.9% normal saline (NS). Student’s t test or Mann-Whitney test and chi-square test were used for statistical analysis. Results The onset of sensory block was significantly faster in the patients in group B as compared to the patients in group A. In terms of the duration of the block, sensory and motor blocks were maintained for a significantly longer duration in the group A patients as compared to those in group B. Moreover, the duration of postoperative analgesia was significantly longer-lasting in the group A patients. In terms of adverse effects, procedure-related complications such as the failure of the block and inadequate block were comparable across the groups. However, drug-related adverse effects were significantly more common in group B. Conclusion As compared to 75 mcg of dexmedetomidine, the addition of 6 mg of dexamethasone as adjuvant to 25 mL of 0.5% bupivacaine resulted in significantly longer-lasting sensory and motor blocks, postoperative analgesia, and a delayed time for first rescue analgesia without increasing undue adverse effects. Dexmedetomidine use is associated with more sedation as compared to dexamethasone.

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Section: Methodsmentioning

confidence: 99%

The Comparison of Dexmedetomidine to Dexamethasone as Adjuvants to Bupivacaine in Ultrasound-Guided Infraclavicular Brachial Plexus Block in Upper Limb Surgeries

Iyengar¹,

Pangotra²,

Kumar³

et al. 2023

Cureus

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“…In the past, tramadol has been widely used in the treatment of shivering after spinal anesthesia ( 20 , 21 ). It mainly inhibits the synaptic reuptake of norepinephrine and 5-HT (hydroxytryptamine), increasing their concentration outside the neurons, thereby increasing the activity of 5-HT and norepinephrine, and then regulates the monoamine downward inhibitory pathway, resulting in an anti-shivering effect ( 22 – 24 ). However, the main side effects of tramadol are nausea and vomiting ( 25 , 26 ), which make the patient quite uncomfortable.…”

Section: Introductionmentioning

confidence: 99%

Comparison of intravenous butorphanol vs. tramadol for post-spinal anesthesia shivering: a meta-analysis and systematic review

Wan,

Li,

Zeng

et al. 2023

Front. Med.

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BackgroundPatients often experience shivering after spinal anesthesia. In recent years, more and more studies have compared the efficacy and side effects of intravenous butorphanol and tramadol in the treatment of shivering after spinal anesthesia. Therefore, we conducted a MATE analysis and systematic review to compare the efficacy and side effects of butorphanol vs. tramadol in the treatment of shivering after spinal anesthesia.MethodsPubMed, Cochrane Library, and Embase databases were searched for randomized controlled trials (RCTs) from inception to 30 December 2022, comparing the effects of butorphanol vs. tramadol for the control of shivering after spinal anesthesia. Data assessment and collection were analyzed using the Review Manager 5.4 software.ResultsFive randomized controlled trials involving 302 adult patients were included in this meta-analysis. The results showed that butorphanol has a shorter time to cease shivering (standardized mean difference (SMD) = −0.53; 95% confidence interval (CI) [−0.89, −0.17], P = 0.004, I2 = 0%), a higher rate of cessation of shivering within 1 min after administering the study drugs (relative risk (RR), 1.69; 95% CI [1.15,2.48], P = 0.008, I2 = 0%), and higher incidences of sedation (RR, 2.98; 95% CI [2.11, 4.21], P <0.00001, I2 = 0%), compared with tramadol.ConclusionIn the treatment of shivering after spinal anesthesia, butorphanol has a shorter onset time and a higher rate of cessation of shivering within 1 min after the study drugs were administered than tramadol. Therefore, butorphanol is superior to tramadol in the treatment of shivering after spinal anesthesia.

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Control of Intraoperative Shivering Under Spinal Anaesthesia- A Prospective Randomized Comparative Study of Nalbuphine With Tramadol

Prajapati¹,

Sorathiya²

2021

PIJR

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spinal anesthesia is a widely used technique for both elective and emergency surgeries. Shivering is one of the most commonly recognized complications of the central neuraxial blockade because of impairment of thermoregulatory control, reported in 40%-70% of the patients undergoing surgery under spinal anaesthesia. Post-anesthetic shivering is defined as an involuntary,spontaneous,rhythmic oscillating muscle hyperactivity that increases metabolic heat production up to 600% after anesthesia. Shivering during neuraxial anesthesia is a common issue that could have possibly adverse impacts, for example, increased oxygen consumption, carbon dioxide production, lung ventilation and cardiac work, as well as causing diminished mixed venous oxygen saturation. Spinal anesthesia impedes the thermoregulatory system by restraining tonic vasoconstriction which assumes significant role in the regulation of temperature

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Randomized double-blinded comparative study of intravenous nalbuphine and tramadol for the treatment of postspinal anesthesia shivering

Cited by 5 publications

References 22 publications

The Comparison of Dexmedetomidine to Dexamethasone as Adjuvants to Bupivacaine in Ultrasound-Guided Infraclavicular Brachial Plexus Block in Upper Limb Surgeries

The Comparison of Dexmedetomidine to Dexamethasone as Adjuvants to Bupivacaine in Ultrasound-Guided Infraclavicular Brachial Plexus Block in Upper Limb Surgeries

Comparison of intravenous butorphanol vs. tramadol for post-spinal anesthesia shivering: a meta-analysis and systematic review

Control of Intraoperative Shivering Under Spinal Anaesthesia- A Prospective Randomized Comparative Study of Nalbuphine With Tramadol

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