AbstractIntroduction: Shivering is a frequent complication reported in 30 to 40% of patients undergoing surgery under regional anaesthesia. It increases oxygen consumption, hypercarbia and minute ventilation. It induces arterial hypoxemia, lactic acidosis, increased intra-ocular pressure, and interferes with patient monitoring and comfort. Most of the studies done in the past have been in the treatment of shivering rather than prevention. This study compared intravenous dexmedetomidine versus intravenous tramadol for prevention of shivering in patients who received spinal anaesthesia for various surgical procedures.
Aims and objectives: The aim of this study was to study and compare the efficacy of intravenous infusion of low dose dexmedetomidine (0.25mcg/kg) vs Tramadol (0.5mg/kg) in the prevention of postoperative shivering. Primary objective was prevention of shivering and Secondary objectives were sedation, hemodynamic changes and nausea and vomiting.
Materials and Methods: Prospective randomised double blinded comparative study was done on patients scheduled for elective surgery during June 2018-March 2019 in GKNM Hospital, Coimbatore. Patients were included as per criteria. Informed and written consent was obtained and randomized by computer. Group D received IV Dexmedetomidine of 0.25mcg/Kg dose and Group T received IV Tramadol of 0.5mg/kg. Data was collected and analyzed. Patients were evaluated post operatively by the investigator who was blinded to the group assigned.
Results: The mean age of the total population was 39.55 ± 11.73 years with male predominance in tramadol group. Dexmedetomedine was more effective in preventing shivering, 16 patients (40%) of group D had shivering compared to 24 patients (60%) of tramadol group. This difference though was not statistically significant, numerically showed that dexmedetomedine was better in prevention of shivering. The tramadol group had early onset of shivering in comparison to Dexmedetomedine group (p<0.05). Dexmedetomedine group had higher grades of sedation and incidence of nausea and vomiting was higher in tramadol group.
Conclusion: Dexmedetomedine even at a lower dose is comparatively a more effective drug for prevention of shivering with fewer side effects than tramadol in patients undergoing surgery under spinal anaesthesia.