The Effect of Tramadol for Control Postoperative Shivering After Spinal Anesthesia
Keywords:
tramadol, spinal anesthesia, shiveringAbstract
The aim of this study was to compare dose of tramadol in the treatment of post-anesthetic shivering (PS) after spinal anesthesia. In this prospective, randomized, double-blind study, 144 patients who undergoing elective surgery under the spinal anesthesia with developed to the shivering. The patients were randomly assigned to receive tramadol 0.5 mg/kg (group 1) and tramadol 1 mg/kg (group 2). The primary outcome was evaluated at 15 minutes after intravenous injection with tramadol and were observed for a recurrence of the shivering within 4 hours. Secondary outcomes included complication. The results showed that, the control rate was success defined with no shivering in groups 1 and 2 were 91.8 % and 93.0 % (p = 0.790). The recurrence rate of the shivering was 12.3% in groups 1 and 11.3% in group 2 respectively (p = 0.844). Nausea and vomiting were found to be significantly lower in group 1 than group 2 (4.1% vs. 18.3%; p = 0.007 and 1.4% vs. 9.9%; p = 0.026 respectively). There was no difference in the other side effects. In conclusion, the treatment of post-anesthetic shivering by use of 0.5 mg/kg and 1 mg/kg of tramadol has no difference results but fewer nausea and vomiting in tramadol 0.5 mg/kg.
References
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2. Sessler DI, Ponte J. Shivering during epidural anesthesia. Anesthesiology. 1990 ;72(5):816-21.
3. Bhattacharya P, Bhattacharya L. Postanaesthetic shivering (PAS): A review. Indian J Anaesth 2003;47(2):88-93.
4. Mohta M, Kumari N, Tyagi A, Sethi AK, Agarwal D, Singh M. Tramadol for prevention of postanaesthetic shivering: a randomised double-blind comparison with pethidine. Anaesthesia 2009;64(2):141-6.
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7. Chan AM, Ng KF, Tong EW, Jan GS. Control of shivering under regional anesthesia in obstetric patients with tramadol. Can J Anaesth 1999;46(3):253-8.
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9. Wrench IJ, Cavill G, Ward JE, Crossley AW. Comparison between alfentanil, pethidine and placebo in the treatment of postanaesthetic shivering. Br J Anaesth 1997;79(4):541-2.
10. Kranke P, Eberhart LH, Roewer N, Tramer MR. Pharmacological treatment of postoperative shivering: a quantitative systematic review of randomized controlled trials. Anesth Analg 2002;94 (2):453-60.
11. Bhatnagar S, Saxena A, Kannan TR, Punj J, Panigrahi M, Mishra S. Tramadol for postoperative shivering: a double-blind comparison with pethidine. Anaesth Intensive Care 2001;29(2):149-54.
12. Atashkhoyi S, Negagar S. Efect of tramadol for prevention of shivering after spinal anesthesia for cesarean section. Res J Biol Sci 2008;3(12):1365-9.
13. Aditi A Dhimar, Mamta G Pate, VN Swadia. Tramadol for control of shivering (Comparison with pethidine) Year. Indian J Anaesth 2007;51(1):28-31.
14. Ezike H, Ajuzieogu J, Amucheazi A, Ewah R, Ajuzieogu JI. Treatment of postanesthetic shivering in children: A randomized control study comparing tramadol to pethidine. Afr J Pharm Pharmacol 2013;7(20):1208-12.
15. Mittal G, Gupta K, Katyal S, Kaushal S. Randomised double-blind comparative study of dexmedetomidine and tramadol for post-spinal anaesthesia shivering. Indian J Anaesth 2014;58(3):257-62.
16. Fern L, Misiran K. Comparison of dexmedetomidine, pethidine and tramadol in the treatment of post-neuraxial anaesthesia shivering. South Afr J Anesth Analg 2015;21(1):14-8.
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18. Shukla U, Malhotra K, Prabhakar T. A comparative study of the effect of clonidine and tramadol on post-spinal anaesthesia shivering. Indian J Anaesth 2011;55(3):242-6.
19. Reddy VS, Chiruvella S. Clonidine versus tramadol for post spinal shivering during caesarean section: A randomized double blind clinical study. J Obstet Anaesth Crit Care 2011;1:26-9.
20. Tsai YC, Chu KS. A comparison of tramadol, amitriptyline, and meperidine for postepidural anesthetic shivering in parturients. Anesth Analg 2001;93(5):1288-92.
21. Kundra TS, Kuthiala G, Shrivastava A, Kaur P. A comparative study on the efficacy of dexmedetomidine and tramadol on post-spinal anesthesia shivering. Saudi J Anaesth 2017;11(1):2-8.
22. Maheshwari BS, Shah SK, Chadha IA. Tramadol and butrophanol for control of shivering: Randomised double blind comparative study. J Anaesth Clin Pharmacol 2008;24:343-6.
23. Joshi SS, Arora A, George A, Shidhaye RV. Comparison of intravenous butorphanol, ondansetron and tramadol for shivering during regional anesthesia: A prospective randomized doubleblind study. Anaesth Pain Intensive Care 2013;17:33-9.
24. Vyas V, Gupta R, Dubey P. Comparative Efficacy and Safety of Intravenous Clonidine and Tramadol for Control of Postspinal Anesthesia Shivering. Anesth Essays Res 2018;12(3):663-8.
25. Morino R, Ozaki M, Nagata O, Yokota M.Incidence of and risk factors for postoperative nausea and vomiting at a Japanese Cancer Center:First large-Scale Study in Japan. J Anesth 2013;27(1):18-24.
26. Gan TJ, Meyer T, Apfel CC, Chung F, Davis PJ, Eubanks S, et al. Consensus guidelines for managing postoperative nausea and vomiting. Anesth Analg 2003;97:62-71.
27. Lehmann KA. Tramadol in acute pain. Drugs 1997;53 Suppl2:25-33.
28. Fiaes GCS, Roncon CM, Sestile CC, Maraschin JC, Souza RLS, Porcu M, et al. Panicolytic-like effect of tramadol is mediated by opioid receptors in the dorsal periaqueductal grey. Behav Brain Res 2017;326:52-58.
2. Sessler DI, Ponte J. Shivering during epidural anesthesia. Anesthesiology. 1990 ;72(5):816-21.
3. Bhattacharya P, Bhattacharya L. Postanaesthetic shivering (PAS): A review. Indian J Anaesth 2003;47(2):88-93.
4. Mohta M, Kumari N, Tyagi A, Sethi AK, Agarwal D, Singh M. Tramadol for prevention of postanaesthetic shivering: a randomised double-blind comparison with pethidine. Anaesthesia 2009;64(2):141-6.
5. Katyal S, Tewari A. Shivering: Anesthetic Considerations. J Anaesth Clin Pharmacol 2002;18:363-76.
6. Mathews S, Al Mulla A, Varghese PK, Radim K, Mumtaz S. Postanaesthetic shivering--a new look at tramadol. Anaesthesia 2002;57(4):394-8.
7. Chan AM, Ng KF, Tong EW, Jan GS. Control of shivering under regional anesthesia in obstetric patients with tramadol. Can J Anaesth 1999;46(3):253-8.
8. Alfonsi P. Postanaesthetic shivering:epidemiology, pathophysiology, and approaches to prevention and management. Drugs 2001;61(15):2193-205.
9. Wrench IJ, Cavill G, Ward JE, Crossley AW. Comparison between alfentanil, pethidine and placebo in the treatment of postanaesthetic shivering. Br J Anaesth 1997;79(4):541-2.
10. Kranke P, Eberhart LH, Roewer N, Tramer MR. Pharmacological treatment of postoperative shivering: a quantitative systematic review of randomized controlled trials. Anesth Analg 2002;94 (2):453-60.
11. Bhatnagar S, Saxena A, Kannan TR, Punj J, Panigrahi M, Mishra S. Tramadol for postoperative shivering: a double-blind comparison with pethidine. Anaesth Intensive Care 2001;29(2):149-54.
12. Atashkhoyi S, Negagar S. Efect of tramadol for prevention of shivering after spinal anesthesia for cesarean section. Res J Biol Sci 2008;3(12):1365-9.
13. Aditi A Dhimar, Mamta G Pate, VN Swadia. Tramadol for control of shivering (Comparison with pethidine) Year. Indian J Anaesth 2007;51(1):28-31.
14. Ezike H, Ajuzieogu J, Amucheazi A, Ewah R, Ajuzieogu JI. Treatment of postanesthetic shivering in children: A randomized control study comparing tramadol to pethidine. Afr J Pharm Pharmacol 2013;7(20):1208-12.
15. Mittal G, Gupta K, Katyal S, Kaushal S. Randomised double-blind comparative study of dexmedetomidine and tramadol for post-spinal anaesthesia shivering. Indian J Anaesth 2014;58(3):257-62.
16. Fern L, Misiran K. Comparison of dexmedetomidine, pethidine and tramadol in the treatment of post-neuraxial anaesthesia shivering. South Afr J Anesth Analg 2015;21(1):14-8.
17. Kyokong O ,Tamdeeb D ,Charuluxananan S. Comparison of the efficacy of nalbuphine, tramadol, ondansetron and placebo in the treatment of postanesthetic shivering after spinal anesthesia for cesarean delivery. Asian Biomed 2007;2(1):189-94.
18. Shukla U, Malhotra K, Prabhakar T. A comparative study of the effect of clonidine and tramadol on post-spinal anaesthesia shivering. Indian J Anaesth 2011;55(3):242-6.
19. Reddy VS, Chiruvella S. Clonidine versus tramadol for post spinal shivering during caesarean section: A randomized double blind clinical study. J Obstet Anaesth Crit Care 2011;1:26-9.
20. Tsai YC, Chu KS. A comparison of tramadol, amitriptyline, and meperidine for postepidural anesthetic shivering in parturients. Anesth Analg 2001;93(5):1288-92.
21. Kundra TS, Kuthiala G, Shrivastava A, Kaur P. A comparative study on the efficacy of dexmedetomidine and tramadol on post-spinal anesthesia shivering. Saudi J Anaesth 2017;11(1):2-8.
22. Maheshwari BS, Shah SK, Chadha IA. Tramadol and butrophanol for control of shivering: Randomised double blind comparative study. J Anaesth Clin Pharmacol 2008;24:343-6.
23. Joshi SS, Arora A, George A, Shidhaye RV. Comparison of intravenous butorphanol, ondansetron and tramadol for shivering during regional anesthesia: A prospective randomized doubleblind study. Anaesth Pain Intensive Care 2013;17:33-9.
24. Vyas V, Gupta R, Dubey P. Comparative Efficacy and Safety of Intravenous Clonidine and Tramadol for Control of Postspinal Anesthesia Shivering. Anesth Essays Res 2018;12(3):663-8.
25. Morino R, Ozaki M, Nagata O, Yokota M.Incidence of and risk factors for postoperative nausea and vomiting at a Japanese Cancer Center:First large-Scale Study in Japan. J Anesth 2013;27(1):18-24.
26. Gan TJ, Meyer T, Apfel CC, Chung F, Davis PJ, Eubanks S, et al. Consensus guidelines for managing postoperative nausea and vomiting. Anesth Analg 2003;97:62-71.
27. Lehmann KA. Tramadol in acute pain. Drugs 1997;53 Suppl2:25-33.
28. Fiaes GCS, Roncon CM, Sestile CC, Maraschin JC, Souza RLS, Porcu M, et al. Panicolytic-like effect of tramadol is mediated by opioid receptors in the dorsal periaqueductal grey. Behav Brain Res 2017;326:52-58.
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Published
2019-08-31
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