Comparative Evaluation of Dexmedetomidine and Tramadol for Attenuation of Post-Spinal Anaesthesia Shivering UC01-UC04
Dr. Dhiraj Bhandari,
Associate Professor, Department of Anaesthesiology, Mahatma Gandhi Institute of Medical Sciences, Wardha-442102, Maharashtra, India.
Introduction: It is important that as anaesthesiologists we understand the adverse effects of hypothermia and shivering on human body which can occur when the patients are anaesthetized, and provide timely intervention. Various non-pharmacological and pharmacological methods have been studied to control intraoperative shivering with varying success. Tramadol and dexmedetomidine have been studied in literature with varying success but few studies have been reported from the Indian subcontinent. Aim: To compare the effects of dexmedetomidine 0.5 µg/kg with tramadol 0.5 mg/kg for treating shivering developed intraoperatively after spinal anaesthesia for patients undergoing lower limb, lower abdominal surgeries, gynaecological procedures and caesarean sections. Materials and Methods: This was a prospective, randomised, double blind comparative study carried out in the Department of Anaesthesiology of a tertiary care Rural Medical College and Hospital. All patients who fulfilled the inclusion criteria and developed post-spinal anaesthesia shivering during the intraoperative course were enrolled and randomised equally into either of the two groups. Group D (n=60) received inj. dexmedetomidine 0.5 µg/kg IV whereas Group T received inj. tramadol 0.5 mg/kg IV after development of post-spinal anaesthesia shivering. Response rate, haemodynamics, recurrence of shivering and complications were monitored. The data was statistically evaluated using STATA version 10 software. Results: A 98.30% of patients shivering ceased after administration of dexmedetomidine, where as success rate was 86.67% in tramadol group. There was early response as well as less recurrence of shivering in dexmedetomidine group. Nausea and vomiting occurred significantly more in tramadol group. There was no significant haemodynamic instability in any group. Conclusion: Dexmedetomidine when used at a dose of 0.5 µg/kg IV is more effective and rapid than tramadol used at a dose of 0.5 mg/kg IV to treat shivering as developed after spinal anaesthesia without any increased side effects as well as inducing a comfortable sedation for the patient.