A Clinical Comparative Study Between Intra Venous Dexmedetomidine And Tramadol For Control Of Post Spinal Anesthesia Shivering
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 4
Abstract
Shivering is a common problem in patients undergoing surgery under spinal anesthesia. Dexmedetomidine and Tramadol have been used to reduce the shivering threshold. The aim of the study was to compare the efficacy of dexmedetomidine and tramadol in the treatment of post-spinal anesthesia shivering as well as to compare their side effect profile. Materials and Methods: A total of 60 American Society of Anaesthesiologist physical status class I and II adult patients (aged 18-65 years) undergoing lower limb surgery under spinal anesthesia and developed shivering received either dexmedetomidine 0.5µg/kg or tramadol 0.5mg/kg intravenously. The response rate, time to cessation of shivering, percentage of recurrence of shivering, seadation score and side effects (if any) was noted.Data was entered in M.S Excel software and analysed using R statistical software. For categorical data two tailed Fishers exact test was used to calculate the significance value (p value) with 95% confidence interval and p value less than0.05 was considered statistically significant. For comparing means of two groups, students t test was used to calculate the significance value (p value) with 95% confidence interval and p value less than 0.05 was considered statistically significant. Results: All the patients had grade III shivering. The time for onset of shivering in group D was 73.26±38.32 minutes and group T was 73.76±40.35 minutes (P value 0.96). The time interval between the drug administration after onset of shivering and cessation of shivering was significantly shorter in group D when compared to group T (172.189±16.32 seconds vs 279.16±24.32 seconds) P < 0.0001. Two patients (6.6%) in group D had recurrence of shivering where as in group T recurrence of shivering occurred in 5 patients (16.5%) and were treated with rescue doses of dexmeditomidine and tramadol respectively. The nausea (28%) and vomiting (8%) was observed only in tramadol group and there was no such incidence observed in group D (P value 0.001). Patients in group D were more sedated (28% in grade 2 score and 72% in grade 3 score) whereas group T 80% of patients had a sedation score 2 (P < 0.001). Conclusion: Both dexmedetomidine (0.5µg/kg) and tramadol (0.5mg/kg) are effective in treating patients with post spinal anaesthesia shivering , but time taken for complete cessation of shivering was shorter with dexmedetomidine as compared to tramadol. Furthermore, dexmedetomidne causes fewer adverse effects like nausea and vomiting. Seadation caused by dexmedetomidine provides additional comfort to the patients.
Authors and Affiliations
Dr Kalapala Ramesh, Dr K. Naga Bhushanam, Dr B Annapurna Sharma, Dr Seelam Surya Sravan Kumar
Keywords
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- DOI 10.9790/0853-1804072631.
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