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Comparison between Butorphanol and Tramadol as an Anti-Shivering Agent in Patients Undergoing Spinal

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Introduction: Shivering can be defined as a physiological response to core hypothermia. Occurrence of shivering is common in patients of regional anesthesia as well as general anesthesia. Shivering cause some serious health consequences so efforts should be taken to prevent or treat at earliest. Aim: To compare efficacy and safety of butorphanol over tramadol as anti-shivering agent under spinal anesthesia and to watch for any side effects. Material and Methods: A prospective randomized comparative study was conducted in 80 patients who developed shivering under spinal anesthesia posted for lower limb orthopedic surgeries. At onset of shivering, patients were randomly allocated in two study groups and study drug was given as slow intravenous injection. Group B - Injection butorphanol (1 mg) 1 ml slow iv. Group T - Injection tramadol (50 mg) 1 ml slow iv. Time taken to complete control of shivering, failure rate, recurrence rate, hemodynamic changes and side effects (nausea, vomiting, itching and sedation) were recorded during study period. Data were collected and analysed using statistical methods. Result: Response rate is similar in both groups. At 1 min post treatment, butorphanol group had more patients with complete control of shivering. There was significantly less chance of reccurence in butorphanol group. Hemodynamic parameters were comparable in both study groups through entire study. Butorphanol treated patients had mild to moderate degree of sedation than tramadol group. Conclusion: Both butorphanol and tramadol are effective in control of shivering under spinal anesthesia. Butorphanol has advantage of faster onset and lesser recurrence rate, only disadvantage being mild to moderate sedation which may warrant observation of respiration.

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Introduction: Shivering can be defined as a physiological response to core hypothermia. Occurrence of shivering is common in patients of regional anesthesia as well as general anesthesia. Shivering cause some serious health consequences so efforts should be taken to prevent or treat at earliest. Aim: To compare efficacy and safety of butorphanol over tramadol as anti-shivering agent under spinal anesthesia and to watch for any side effects. Material and Methods: A prospective randomized comparative study was conducted in 80 patients who developed shivering under spinal anesthesia posted for lower limb orthopedic surgeries. At onset of shivering, patients were randomly allocated in two study groups and study drug was given as slow intravenous injection. Group B - Injection butorphanol (1 mg) 1 ml slow iv. Group T - Injection tramadol (50 mg) 1 ml slow iv. Time taken to complete control of shivering, failure rate, recurrence rate, hemodynamic changes and side effects (nausea, vomiting, itching and sedation) were recorded during study period. Data were collected and analysed using statistical methods. Result: Response rate is similar in both groups. At 1 min post treatment, butorphanol group had more patients with complete control of shivering. There was significantly less chance of reccurence in butorphanol group. Hemodynamic parameters were comparable in both study groups through entire study. Butorphanol treated patients had mild to moderate degree of sedation than tramadol group. Conclusion: Both butorphanol and tramadol are effective in control of shivering under spinal anesthesia. Butorphanol has advantage of faster onset and lesser recurrence rate, only disadvantage being mild to moderate sedation which may warrant observation of respiration.

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This page is a summary of: Comparison between Butorphanol and Tramadol as an Anti-Shivering Agent in Patients Undergoing Spinal Anesthesia for Lower Limb Orthopedic Surgeries, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6319.46.
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