Comparative assessment of clonidine and tramadol on post-spinal anaesthesia shivering among patients with lower abdominal and lower limb surgeries

Abstract

Background: Shivering is a potentially serious complication, resulting in increased metabolic rate; increased oxygen consumption (up to 100-600%) along with raised carbon dioxide (CO2) production; ventilation and cardiac output; adverse postoperative outcomes, such as wound infection; increased surgical bleeding; and morbid cardiac events. It causes arterial hypoxemia, lactic acidosis, increased intraocular pressure (IOP), increased intracranial pressure (ICP); and interferes with pulse rate, blood pressure (BP) And electrocardiographic (ECG) monitoring. Materials and Methods: The present study was conducted in the Department of Anesthesia of the MGM medical College, Navi Mumbai. The present study was a randomized controlled trial which was conducted after obtaining institutional ethics committee approval. It was conducted among 100 patients aged between 18 to 70 years, who were scheduled for abdominal and lower limb surgeries and who developed shivering following spinal anaesthesia. These 100 patients of ASA grade I and II which were selected randomly after taking informed and written consent from their relatives. Results: Out of 50 patients in Group C, shivering subsided in 48 patients. While in group T, shivering subsided in 44 patients out of 50. There was significant difference in both groups for control of shivering which proved that the rate of success after clonidine was more than that of tramadol. Conclusion: Both clonidine (75 μg) and tramadol (0.5 mg/kg) can effectively treat patients with postspinal anaesthesia shivering, but tramadol took longer time for complete cessation of shivering than clonidine. Both clonidine (75 μg) and tramadol (0.5 mg/ kg) can effectively treat patients with postspinal anaesthesia shivering, but tramadol took longer time for complete cessation of shivering than clonidine.

The effects of intravenous tramadol vs. intravenous ketamine in the prevention of shivering during spinal anesthesia: A meta-analysis of randomized controlled trials

“…Shivering may have beneficial thermoregulatory effects; however, it is a distressing experience and causes several undesirable detrimental effects ( 8 ). It leads to an increase in oxygen consumption and carbon dioxide production, intraocular and intracranial pressure ( 9 – 11 ). It may also lead to an increase in sympathetic tone that enhances the chances of myocardial ischemia ( 12 , 13 ), pain ( 14 ), and bleeding ( 15 ).…”