Comparison of Dexmedetomidine with Tramadol for Treatment of Shivering Post Spinal Anaesthesia
DOI:
https://doi.org/10.51253/pafmj.v73i6.6345Keywords:
Dexmedetomidine, Efficacy, Shivering, Spinal, TramadolAbstract
Objective: To compare the efficacy of Dexmedetomidine with Tramadol for shivering post-spinal anaesthesia.
Study Design: Quasi-experimental study.
Place and Duration of Study: Department of Anaesthesia, Combined Military Hospital, Rawalpindi Pakistan, from Jul to Dec 2020.
Methodology: A total of 158 patients who underwent gynaecological, orthopaedic and general surgical procedures under
spinal anaesthesia using 0.5% hyperbaric Bupivacaine 12-15 mg were included in the study. Out of these 158 patients, 64%
(102 patients) developed shivering after spinal anaesthesia. These 102 patients were divided into two equal groups, i.e.,
Group-D (n=51), who received 0.5 μg/kg Dexmedetomidine and Group-T (n=51), who received 0.5 mg/kg tramadol. The
response in the next 15 mins was evaluated objectively as “effective” or “non-effective” by the treating Anesthesiologist.
Results: Dexmedetomidine and Tramadol were effective in treating shivering following spinal anaesthesia. Our study showed that Dexmedetomidine was more effective than Tramadol in treating shivering, with an effectiveness of 88.2 % shivering relief in Group-D and an effectiveness of 51 % shivering relief in Group-T. The effectiveness was significant in both groups, with statistical significance in Group-D compared to Group-T (p<0.05).
Conclusion: Shivering relief was more responsive in patients who received Dexmedetomidine than Tramadol after spinal
anaesthesia.
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Fern L, Misiran K. Comparison of dexmedetomidine, pethidine and tramadol in the treatment of post-neuraxial anaesthesiashivering. South Afr J Anaesth Analg 2015; 21(1): 14-18.https://doi.org/10.1080/22201181.2015.1013323.
Botros JM, Mahmoud AMS, Ragab SG. Comparative studybetween Dexmedetomidine and Ondansteron for prevention of
post spinal shivering. A randomized controlled trial. BMCAnesthesiol 2018 30; 18(1): 179-182.https://doi.org/10.1186/s12871-018-0640-3.
Abdel-Ghaffar HS, Mohamed SA, Fares KM, Osman MA. Safetyand Efficacy of Dexmedetomidine in Treating Post Spinal
Anesthesia Shivering: A Randomized Clinically Controlled DoseFinding Trial. Pain Physician 2016; 19(4): 243-253.
Moeen SM, Moeen AM. Intrathecal dexamethasone vs.meperidine for prevention of shivering during transurethral
prostatectomy: a randomized controlled trial. Acta AnaesthesiolScand 2017; 61(7): 749-757. https://doi.org/10.1111/aas.12920.
Mittal G, Gupta K, Katyal S, Kaushal S. Randomised doubleblind comparative study of dexmedetomidine and tramadol forpost-spinal anaesthesia shivering. Indian J Anaesth 2014; 58(3):257-262. https://doi.org/10.4103/0019-5049.135031.
Safavi M, Honarmand A, Rahmanikhah E, Badiei S, Attari M.Intrathecal Meperidine versus intrathecal Fentanyl for
prevention of shivering in lower limb orthopedic surgeries underspinal anesthesia: A randomized double-blind placebocontrolled trial. J Res Pharm Pract 2014; 3(4): 137-41.https://doi.org/10.4103%2F2279-042X.145390.
Yu G, Jin S, Chen J, Yao W, Song X. The effects of novel α2-adrenoreceptor agonist dexmedetomidine on shivering in
patients underwent caesarean section. Biosci Rep 2019; 39(2):BSR20181847. https://doi.org/10.1042/bsr20181847
Shukla D, Verma A. Comparative study of intrathecaldexmedetomidine with intrathecal magnesium sulfate used as
adjuvants to bupivacaine. J Anaesthesiol Clin Pharmacol 2011;27(4): 495-499. https://doi.org/10.4103/0970-9185.86594
Xiao F, Xu W, Feng Y, Fu F, Zhang X. Intrathecal magnesiumsulfate does not reduce the ED50 of intrathecal hyperbaric
bupivacaine for cesarean delivery in healthy parturients: aprospective, double blinded, randomized dose-response trial
using the sequential allocation method. BMC Anesthesiol 2017;17(1): 8. https://doi.org/10.1186/s12871-017-0300-z
Xia F, Chang X, Zhang Y, Wang L, Xiao F. The effect of intrathecal dexmedetomidine on the dose requirement of hyperbaricbupivacaine in spinal anaesthesia for caesarean section:a prospective, double-blinded, randomized study. BMC
Anesthesiol 2018; 18(1): 74-76.https://doi.org/10.1186%2Fs12871-018-0528-2.
Tang Y, Yang M, Fu F, Huang X, Feng Y, Chen X, et al.Comparison of the ED50 of intrathecal hyperbaric ropivacaine
co-administered with or without intrathecal dexmedetomidinefor cesarean section: A prospective, double-blinded, randomizeddose-response trial using up-down sequential allocation method.J Clin Anesth 2020; 62(1): 109725.
https://doi.org/10.1016/j.jclinane.2020.109725.
Gautam B, Niroula S, Sharma M, Lama SM. Effects of IntrathecalDexmedetomidine as an Adjuvant to Hyperbaric Bupivacaine forSpinal Anaesthesia in Adults Undergoing Elective InfraUmbilical Surgery. J Nepal Med Assoc 2017; 56(208): 379-387.
Shami S, Nasseri K, Shirmohammadi M, Sarshivi F, Ghadami N,Ghaderi E, et al. Effect of low dose of intrathecal pethidine on theincidence and intensity of shivering during cesarean sectionunder spinal anesthesia: a randomized, placebo-controlled,double-blind clinical trial. Drug Des Devel Ther 2016; 10(374):3005-3012. https://doi.org/10.2147%2FDDDT.S115201.
Samantaray A, Hemanth N, Gunnampati K, Pasupuleti H,Mukkara M, Rao MH, et al. Comparison of the effects of adding
dexmedetomidine versus midazolam to intrathecal bupivacaineon postoperative analgesia. Pain Physician 2015; 18(1): 71-77.
Nasseri K, Ghadami N, Nouri B. Effects of intrathecaldexmedetomidine on shivering after spinal anesthesia for
cesarean section: a double-blind randomized clinical trial. DrugDes Devel Ther 2017; 11(330): 1107-1113.https://doi.org/10.2147/dddt.s131866.
Hidayah MN, Liu CY, Joanna OS. Ketamine and tramadol for theprevention of shivering during spinal anaesthesia. Clin Ter 2014;165(4): 193-198. https://doi.org/10.7417/ct.2014.1732.
He L, Xu JM, Liu SM, Chen ZJ, Li X, Zhu R, et al. IntrathecalDexmedetomidine Alleviates Shivering during Cesarean
Delivery under Spinal Anesthesia. Biol Pharm Bull 2017; 40(2):169-173. https://doi.org/10.1248/bpb.b16-00651
Gautam B, Tabdar S, Shrestha U. Comparison of Fentanyl andDexmedetomidine as Intrathecal Adjuvants to SpinalAnaesthesia for Abdominal Hysterectomy. J Nepal Med Assoc2018 ; 56(213): 848-855. https://doi.org/10.31729/jnma.3739
Venkatraman R, Karthik K, Pushparani A. A prospective,randomized, double-blinded control study on comparison of
tramadol, clonidine and dexmedetomidine for post spinalanesthesia shivering. Rev Bras Anestesiol 2018; 68(1): 42-48.
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