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Butorphanol and Intravenous Tramadol for Control Intra-operative Shivering Under Spinal Anesthesia

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Background: Shivering is one of the complications of central neuraxial blockade due to impairment of thermoregulatory control. Control of post spinal anesthesia shivering is essential for optimal peri-operative care which can be achieved by non-pharmacological and pharmacological means. Aim: The present study was designed to evaluate and compare the efficacy of intravenous Butorphanol and Tramadol for control of intraoperative shivering under spinal anesthesia. Material & Methods: In this prospective, interventional double blind, randomized study, 60 ASA I/II patients, aged 18–60 years, undergoing elective lower abdominal, urological and lower limb surgeries under spinal anesthesia, who subsequently developed shivering of grade 3 or 4, were randomized into two groups, to receive Tramadol 1 mg/kg or Butorphanol 0.03 mg/kg. Time taken to control shivering, response rate, recurrence rate and side effects such as nausea, vomiting, dry mouth, respiratory depression and sedation were observed. Results: Butorphanol had rapid onset of action for control of shivering as compared to Tramadol (p<0.05). The incidence of recurrence was significantly higher with Tramadol compared to Butorphanol while as sedation was found to be significantly higher with Butorphanol as compared to Tramadol. Side effects such as nausea, vomiting was significantly higher with Tramadol. Conclusion: Both Intravenous Butorphanol and Tramadol are effective treatment for control of shivering following spinal anaesthesia. Butorphanol is superior to Tramadol for control of shivering post spinal anaesthesia in several respects like rapid onset of action, lesser recurrence and lesser incidence of nausea and vomiting.

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Background: Shivering is one of the complications of central neuraxial blockade due to impairment of thermoregulatory control. Control of post spinal anesthesia shivering is essential for optimal peri-operative care which can be achieved by non-pharmacological and pharmacological means. Aim: The present study was designed to evaluate and compare the efficacy of intravenous Butorphanol and Tramadol for control of intraoperative shivering under spinal anesthesia. Material & Methods: In this prospective, interventional double blind, randomized study, 60 ASA I/II patients, aged 18–60 years, undergoing elective lower abdominal, urological and lower limb surgeries under spinal anesthesia, who subsequently developed shivering of grade 3 or 4, were randomized into two groups, to receive Tramadol 1 mg/kg or Butorphanol 0.03 mg/kg. Time taken to control shivering, response rate, recurrence rate and side effects such as nausea, vomiting, dry mouth, respiratory depression and sedation were observed. Results: Butorphanol had rapid onset of action for control of shivering as compared to Tramadol (p<0.05). The incidence of recurrence was significantly higher with Tramadol compared to Butorphanol while as sedation was found to be significantly higher with Butorphanol as compared to Tramadol. Side effects such as nausea, vomiting was significantly higher with Tramadol. Conclusion: Both Intravenous Butorphanol and Tramadol are effective treatment for control of shivering following spinal anaesthesia. Butorphanol is superior to Tramadol for control of shivering post spinal anaesthesia in several respects like rapid onset of action, lesser recurrence and lesser incidence of nausea and vomiting.

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This page is a summary of: Comparative Study of Intravenous Butorphanol and Intravenous Tramadol for Control of Intra-operative Shivering Under Spinal Anesthesia, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6319.28.
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