Bupivacaine alone to Control Shivering in Patients Undergoing Caesarean Surgery

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Bupivacaine alone to Control Shivering in Patients Undergoing Caesarean Surgery

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Context: It’s important to prevent shivering in parturient undergoing caesarean surgery under spinal anaesthesia as shivering results in increased metabolic rate, CO2 and oxygen consumption. Aims: Intrathecal tramadol as an adjuvant to bupivacaine, to assess incidence and grading of post spinal shivering, onset and duration of sensory and motor block, haemodynamic changes and APGAR score of the new born. Material and methods: Thirty patients aged 21-35 years of ASA I & II posted for elective or emergency caesarean section were randomly allocated into two groups. Group B (n=15) received inj. bupivacaine 0.5% heavy 2 ml+0.2 ml 0.9% normal saline and group T (n=15) received inj. bupivacaine 0.5% heavy 2 ml+inj. tramadol 0.2 ml (10 mg) preservative free intrathecally. Statistical analysis: The statistical analysis was assessed by unpaired students t-test and Chi square test. Results: Intra-operatively, shivering in 66.67% compared to 13.3% and post-operatively in 80% compared to 6.67% was seen, in group B & group T respectively. Onset of sensory blockade was 8.33 ± 0.90 minutes versus 9.20±0.68 minutes and motor blockade was 11.13 ± 0.834 minutes versus 12.00 ± 0.756 minutes, in group T and group B respectively whereas, duration of sensory and motor blockade were prolonged in group T (p<0.05). No differences in APGAR score, hemodynamic parameters and incidence of complication between both groups. Conclusion: Intrathecal tramadol significantly reduces the incidence of shivering in parturient undergoing caesarean surgery without significant adverse effect on mother and neonates while having early onset of both motor and sensory components in subarachnoid block.

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