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Double Blind Study of Dexmedetomidine Versus Tramadol for Post-Spinal Anaesthesia Shivering

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Why is it important?

Shivering is one of the most common complications of a central neuraxial blockade. Shivering is defined as involuntary, spontaneous, oscillatory mechanical activity of skeletal muscle associated with increased oxygen consumption. Shivering can be thermo regulatory or non thermo regulatory. Its mere presence per operatively is very unpleasant and even physiologically stressful. It is managed per operative either by non pharmacological means such as warm blankets, drapes, warm intravenous fluids or by pharmacological means using various drugs like intravenous opioids, HT3 antagonists, Dexmedetomidine (α-2 agonist). Our study was planned to study the efficacy of Dexmedetomidine with that of Tramadol for control of shivering after spinal anesthesia given in patients for various surgical indications. 60 Patients of age group 15-70 years of ASA grade I & II were divided in two groups Group D (to receive Inj. Dexmedetomidine 0.5 µg/kg intravenously slowly) and Group T (to receive Inj. Tramadol 1 mg/kg intravenously slowly) intra operatively who developed shivering of the Grade 3 and 4. We found that Dexmedetomidine in the dose of 0.5 µg/kg intravenously controls shivering faster than Tramadol 1 mg/kg, reduces patient discomfort experience time, and also induces sedation without any nausea and vomiting. Hence Dexmedetomidine seems to be a better alternative to Tramadol for per operative and post operative shivering during central neuraxial blockade.

Perspectives

Shivering is one of the most common complications of a central neuraxial blockade. Shivering is defined as involuntary, spontaneous, oscillatory mechanical activity of skeletal muscle associated with increased oxygen consumption. Shivering can be thermo regulatory or non thermo regulatory. Its mere presence per operatively is very unpleasant and even physiologically stressful. It is managed per operative either by non pharmacological means such as warm blankets, drapes, warm intravenous fluids or by pharmacological means using various drugs like intravenous opioids, HT3 antagonists, Dexmedetomidine (α-2 agonist). Our study was planned to study the efficacy of Dexmedetomidine with that of Tramadol for control of shivering after spinal anesthesia given in patients for various surgical indications. 60 Patients of age group 15-70 years of ASA grade I & II were divided in two groups Group D (to receive Inj. Dexmedetomidine 0.5 µg/kg intravenously slowly) and Group T (to receive Inj. Tramadol 1 mg/kg intravenously slowly) intra operatively who developed shivering of the Grade 3 and 4. We found that Dexmedetomidine in the dose of 0.5 µg/kg intravenously controls shivering faster than Tramadol 1 mg/kg, reduces patient discomfort experience time, and also induces sedation without any nausea and vomiting. Hence Dexmedetomidine seems to be a better alternative to Tramadol for per operative and post operative shivering during central neuraxial blockade.

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This page is a summary of: Randomised Double Blind Study of Dexmedetomidine Versus Tramadol for Post Spinal Anaesthesia Shivering, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6319.29.
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