The minimum effective doses of pethidine and doxapram in the treatment of post‐anaesthetic shivering

Wrench, I.; Singh, Prince Kumar; Dennis, A. R.; Mahajan, R.P.; Crossley, A. W. A.

doi:10.1111/j.1365-2044.1997.006-az006.x

Cited by 100 publications

(57 citation statements)

References 8 publications

(15 reference statements)

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“…Earlier studies [4] have found that use of 1 mg/kg of Tramadol was associated with higher incidence of nausea and vomiting, and also sedation, which was not observed in our study. Some others [7] have suggested that slow injection of Tramadol over two minutes, reduces and prevents nausea and vomiting.…”

Section: Discussioncontrasting

confidence: 52%

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

Kaparti

2014

JCDR

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Section: Discussioncontrasting

confidence: 52%

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

Kaparti

2014

JCDR

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“…Nas situações em que a meperidina não pode ser usada os autores sugerem o uso de clonidina (150 µg), cetanserina (10 mg), alfentanil (0,25 mg) ou doxapram (100 mg). Deve ser lembrado que a manutenção da temperatura corporal intra-operatória e o uso de cobertores com ar aquecido no intra-e pós-operatório diminuem a necessidade de medicamentos para tratamento de tremores 76 . Em estudo realizado em 220 pacientes com o objetivo de identificar a dose eficaz de meperidina para o tratamento de tremores, Crossley 76 concluiu que 0,35 mg.kg -1 é a menor quantidade necessária para tratar tremor pós-operató-rio de forma satisfatória.…”

Section: Tratamento Dos Tremores Pós-operatóriosunclassified

“…Deve ser lembrado que a manutenção da temperatura corporal intra-operatória e o uso de cobertores com ar aquecido no intra-e pós-operatório diminuem a necessidade de medicamentos para tratamento de tremores 76 . Em estudo realizado em 220 pacientes com o objetivo de identificar a dose eficaz de meperidina para o tratamento de tremores, Crossley 76 concluiu que 0,35 mg.kg -1 é a menor quantidade necessária para tratar tremor pós-operató-rio de forma satisfatória. O uso do tramadol para tratamento de tremores tem sido feito nos últimos anos, e a sua eficácia é semelhante à da meperidina segundo alguns estudos 77 .…”

Section: Tratamento Dos Tremores Pós-operatóriosunclassified

“…In situations that meperidine cannot be used, the authors suggest the use of clonidine (150 µg), ketanserin (10 mg), alfentanil (0.25 mg), or doxapram (100 mg). It should be mentioned that the intraoperative maintenance of body temperature and the use of warm air blankets decreased the need of drugs for the treatment of tremors 76 . In a study with 220 patients aiming at identifying the effective dose of meperidine for the treatment of tremors, Crossley 76 concluded that 0.35 mg.kg -1 is the smallest dose necessary to treat adequately postoperative tremors.…”

Section: Treatment Of Postoperative Tremorsmentioning

confidence: 99%

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Tremores intra e pós-operatório: prevenção e tratamento farmacológico

Albergaria

Lorentz²,

Lima³

2007

Rev. Bras. Anestesiol.

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RESUMOAlbergaria VF, Lorentz MN, Lima FAS -Tremores Intra e Pós-Operatório: Prevenção e Tratamento Farmacológico. JUSTIFICATIVA E OBJETIVOS:Os tremores podem ocorrer como um efeito adverso da intervenção cirúrgica e anestesia. A incidência de tremores pós-operatórios varia entre 6,3% e 66%. Pacientes jovens, sexo masculino, uso de agentes anestésicos halogenados e tempo prolongado de anestesia ou procedimento cirúrgico estão relacionados com tremores. Os tremores são involuntários e apresentam-se como atividade muscular oscilatória com finalidade de aumentar a produção de calor. Tremor pós-operatório é uma desagradável complicação que está relacionada com o aumento de morbidade. O tremor aumenta o metabolismo, resultando em um acréscimo de 200% a 500% no consumo de oxigênio. CONTEÚDO:Discute as causas, a prevenção e o tratamento dos tremores intra-e pós-operatório em pacientes adultos e pediátri-cos submetidos à intervenção cirúrgica sob anestesia geral ou do neuroeixo. CONCLUSÕES:Os tremores são, juntamente com náuseas e vô-mitos, causas de intenso desconforto na sala de recuperação pós-anestésica, além de potencialmente prejudiciais por gerarem aumento da demanda metabólica. Embora a presença de tremores não tenha sido diretamente relacionada com a morbidade cardía-ca, a prevenção tem se tornado tema de debate e de vários artigos científicos. A prevenção e o tratamento de tremores devem ser implementados. Pacientes com reserva cardiopulmorar limitada podem sofrer com acidose láctica, dessaturação venosa mista e hipoxemia.Unitermos: ANESTESIA: Geral, Locorregional; COMPLICAÇÕES: hipotermia, tremor; TREMOR: prevenção, tratamento. SUMMARYAlbergaria VF, Lorentz MN, Lima FAS -Intra-and Postoperative Tremors: Prevention and Pharmacological Treatment. BACKGROUND AND OBJECTIVES:Tremors can be an adverse effect of the surgical intervention and anesthesia. The incidence of postoperative tremors varies from 6.3% to 66%. Young age, male gender, the use of halogenated anesthetics, and prolonged anesthesia or surgical procedure are related with tremors. Tremors are involuntary and present as oscillating muscular activity aiming at increasing heat production. Postoperative tremors are a disagreeable complication related with increased morbidity. Tremors increase the metabolism, resulting in a 200% to 500% increase in oxygen consumption. CONTENTS:The objective of this paper was to discuss the causes, prevention, and treatment of intra-and postoperative tremors in adults and children undergoing general anesthesia or neuroaxis anesthesia for surgical interventions. CONCLUSIONS:Tremors, along with nausea and vomiting, cause severe discomfort in the recovery room, besides being highly prejudicial because they generate an increase in the metabolism. Although the presence of tremors has not been directly related with cardiac morbidity, its prevention has become the subject of discussion and several scientific reports. Prevention and treatment of tremors should be implemented. Patients with limited cardiovascular reserve could devel...

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“…tramadol 50mg i.v. Grading of shivering was done as per wrench [15] , which is as follows: Grade 0: No shivering, Grade 1: One or more of the following: Piloerection, Peripheral vasoconstriction, peripheral cyanosis with, but without visible muscle activity, Grade 2: Visible muscle activity confined to one muscle group, Grade 3: Visible muscle activity in more than one muscle group, Grade 4: Gross muscle activity involving the whole body. The study drug was administered slowly IV as per the allotted group.…”

Section: Preoperative Managementmentioning

confidence: 99%

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

Attal¹,

Chhaya²,

Singh³

et al. 2015

Int J of Biomed & Adv Res

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Objectives: This study aimed to evaluate the relative efficacy of intravenously administered clonidine and tramadol for control of intraoperative shivering following spinal anaesthesia. Materials and Methods: A prospective, randomized, clinical controlled study was conducted on 60 ASA grade-I &II patients of either sex, aged 18-40 years, scheduled for elective lower abdominal and lower limb surgeries, under spinal anaesthesia. Patients who developed post spinal intraoperative shivering of grades 3 or 4, lasting for minimum period of 2minutes were included in the study, and randomly allocated to one of the two groups, group C (n=30), received Inj. clonidine 50µg i.v., and group T (n=30), received Inj. tramadol 50mg i.v. when shivering was observed. Time taken for control of shivering, response rate, recurrence rate, and side effects were observed. Results: The response rate was significantly higher in tramadol group than clonidine group at 1min, 2mins, and 3mins and 5mins intervals and comparable in both groups at 15 mins. The average time taken for disappearance of shivering was higher in clonidine group i.e. 5.76 ± 0.88mins as against 3.16 ± 0.84mins in tramadol group (P=0.038). Patients with incomplete response and recurrence were more in clonidine group. Side effects like hypotension, bradycardia, sedation and dry mouth were observed in clonidine group patients, and nausea and vomiting in tramadol group, but were controllable. Conclusion: Tramadol is better as compared to clonidine for control of intraoperative shivering under spinal anaesthesia due to rapid onset, higher response rate, lesser recurrence, lesser sedation and lesser hemodynamic alterations.

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The minimum effective doses of pethidine and doxapram in the treatment of post‐anaesthetic shivering

Cited by 100 publications

References 8 publications

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

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

Tremores intra e pós-operatório: prevenção e tratamento farmacológico

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

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