Tramadol in perioperative shivering in patients undergoing caesrean section under regional anaesthesia
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 5, Issue 2
Abstract
Background: Shivering can be unpleasant and physiologically stressful for the patients. The incidence of post-operative shivering is more in obstetric patients. Many physical and pharmacological interventions are used to decrease the incidence and severity of post anaesthetic shivering. Among pharmacological interventions, tramadol, a synthetic opioid is found effective in many studies, with the advantage of causing less respiratory depression and sedation. Methods: The present study was undertaken at St Martha’s hospital Nrupatunga road, Bangalore. Atotal of 240 obstetric patients of ASA G 1 and 2, posted for elective and emergency caesarean section under regional anaesthesia, who developed subsequently shivering were studied. Patients were randomly divided into three groups. Group 1(80 patients who have received 0.25mg /kg), Group 2 (80 patients who have received 0.5mg/kg), Group 3 (80 patients who have received 1mg/kg). The attending anaesthesiologist observed for cessation of shivering and the time elapsed from treatment to the time shivering subsided. If shivering did not subside by the end of 15 minutes, treatment was considered ineffective.Statistical analysis of the data was done by Anova, chi Square, Kruskal Wallis test, fisher exact test. Results: Statistical analysis revealed significantly better response with Tramadol 0.5mg /kg (90%) and tramadol (1mg /kg), compared with 0.25mg/kg (25%) of tramadol. Vitals were not altered in any of the groups and none of the above doses induced significant sedation or unduly affected the APGAR scores of the new born. Conclusion: From the above study it can be concluded that 0.5mg/kg is the minimum effective dose of tramadol for control of shivering in obstetric patients.
Authors and Affiliations
Lakshmi A S, Bhavya Reddy H A
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