Postanaesthetic shivering ‐ a new look at tramadol

Abstract

We studied whether tramadol administered at the time of wound closure can prevent postanaesthetic shivering. One hundred and fifty patients scheduled for general anaesthesia and surgery were randomly allocated and tramadol was administered intravenously at a dose of 2 mg.kg(-1) in the high-dose group, 1 mg.kg- in the low-dose group and 0.9% saline in the control group. In the high-dose group, 2% of patients had postanaesthetic shivering, compared to 4% in the low-dose group and 48% in the control group (p < 0.001 vs. tramadol groups). There was no delay in tracheal extubation after reversal of neuromuscular blockade. The incidence of adverse side-effects such as sedation and vomiting did not differ statistically and were clinically not significant. This study strongly supports the use of tramadol at wound closure for prevention of postanaesthetic shivering.

Comparisons of tramadol with pethidine for prevention of post anaesthetic shivering in elective abdominal surgery

“…Our second test drug, tramadol, was previously shown by Trekova 14 to be more effective than the placebo and without any adverse effects. Also, Mathew et al 12 showed the effectiveness of tramadol for prevention of post operative shivering as dose of 1 and 2 mg/kg with respective success rate of 96% and 98%, which are in the same range as our result of 100% success rate with a dose of 1mg/kg.…”

A Randomised Trial Comparing Efficacy, Onset and Duration of Action of Pethidine and Tramadol in Abolition of Shivering in the Intra Operative Period

“…However, in our study the complete disappearance of shivering occurred by the end of seven minutes in case of Tramadol and 15 min in Pethidine. Earlier studies have showed better results with Tramadol group [10,15].…”

“…It also modulates the activity of nucleus median raphe acting centrally on the m opioid receptors predominately with minimum effects on k and d receptors. The antishivering effect of tramadol is mediated via serotonergic of noradrenertic receptor or both [10][11][12]. Tramadol in a dose of 1mg/ kg iv has been shown to be effective in the treatment of postoperative shivering.…”

Comparison of clonidine and tramadol for the control of shivering under spinal anaesthesia

“…It has a modulatory effect on central monoaminergic pathways, and thus inhibits the neuronal uptake of noradrenaline/serotonin and encourages hydroxytriptamine secretion which resets the body temperature regulation centre and has shown to be effective in controlling post spinal shivering. [7] Clonidine is an α 2 -adrenoceptor agonist. It exerts its anti-shivering effects at three levels: Hypothalamus, locus coeruleus and spinal cord.…”