Control of shivering under regional anesthesia in obstetric patients with tramadol

Abstract

Control of shivering under regional anesthesia in obstetric patients with tramadolPurpose: Tramadol in a dose of I mg'kg -~ iv is effective in the treatment of shivering after general anesthesia. The current study aimed to investigate (I) whether tramadol was equally effective for shivering under regional anesthesia in obstetric patients and (2) whether effective treatment could be achieved with lower doses. Methods: In a randomised, double-blind study, 36 obstetric patients who shivered during Cesarean section under regional anesthesia and who requested anti-shivering treatment were allocated to one of three groups for iv treatment: Group T0.5 received tramadol 0.5 mg'kg -l (n= 12), Group T0.25 tramadol 0.25 mg'kg -I (n--13) and Group NS normal saline 0.05 mlkg -l (n= I I). Treatment efficacy was evaluated subjectively by the parturient as no improvement, slight improvement, or marked improvement. The attending anesthesiologist who was blinded also independently noted the time elapsed from treatment to the time shivering subsided. Side effects such as nausea, vomiting or sedation and Apgar scores of the newborn were also noted. l~sults: Eighty percent of parturients in Group T0.5 and 92% in Group T0.25 were judged by observers to have shivering controlled compared with 27% in Group NS (P < 0.00 I). The response rates of Group T0.5 and Group T0.25 were not different. There was no increased incidence of side effects in the treatment groups. Conclusion: We conclude that tramadol iv was effective in the treatment of intraoperative shivering during regional anesthesia for Cesarean section. There was no demonstrable difference in response rate or incidence of side effects between the two doses of 0.5 mg.kg-' and 0.25 mg-kg -J.Objecdf : Le tramadol en dose de I mg-kg-' iv est efficace pour le traitement des frissons apr& l'anesth~sie gEnErale. La pr&ente Etude veut analyser (I) si le tramadol est Egalement efficace contre les frissons sous anesth&ie obst&ricale rEgionale et (2) si le traitement efficace peut se faire avec de plus faibles doses. M&hodc : Dans une Etude randomisEe et ~ double insu, 36 parturientes atteintes de frissons pendant la cEsarienne sous anesth&ie rEgionale ont ErE rEparties en trois groupes pour recevoir un traitement de tramadol iv : le Groupe T0,5 en a re~u 0,5 mg-kg-' (n = 12), le Groupe T0,25 en a re~u 0,25 mg.kg-' (n = 13) et le Groupe SN a eu 0,05 ml.kg-' de solution saline normale (n = I I). ['efficacitE du traitement a EtE Evalu& subjectivement par les parturientes : aucune amelioration, IEg&e amelioration ou importante amelioration. De son c6tE, l'anesthEsiologiste traitant, observateur impartial, a not~ le temps &oul~ entre le traitement et la fin des frissons. On a aussi enregistrE les effets secondaires comme les nausEes, les vomissements ou la s~dation et les indices d'Apgar du nouveau-n& REsultats : Quatre-vingt pour cent des parturientes du Groupe T0,5 et 92 % de celles du Groupe T0,2S ont bEnEficiE du traitement des frissons selon les observateurs, mais 27 96 seulement des patie...

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Comparative Study of Tramadol with That of Butorphanol for the Control of Shivering in Patients Undergoing Neuraxial Blockade

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