Comparative Efficacy and Safety of Intravenous Clonidine and Tramadol for Control of Postspinal Anesthesia Shivering.

Abstract

BACKGROUND:

Shivering is a common problem in patients undergoing surgery under spinal anesthesia.

AIMS:

The aim of this study was to compare efficacy and safety of clonidine versus tramadol in postspinal anesthesia shivering.

SETTINGS AND DESIGN:

This prospective, randomized, double-blind controlled clinical trial was conducted in a tertiary care setting.

MATERIALS AND METHODS:

A total of 60 American Society of Anesthesiologists physical status Class l and II adult patients (age 18-65 years) undergoing surgery under spinal anesthesia and developed shivering received either clonidine 1 μg/kg or tramadol 1 mg/kg intravenously. The time required for cessation of shivering, control and recurrence rate of shivering, effect on hemodynamics and side effects were compared between two groups.

STATISTICAL ANALYSIS:

Unpaired t-test and Chi-square test were used for comparison of continuous variables and dichotomous data between two groups, respectively. P < 0.05 was considered as statistically significant.

RESULTS:

Time for cessation of shivering was less in clonidine group than tramadol group (02.51 vs. 04.82 min; P < 0.001). Complete control of shivering was achieved in 80% of patients in clonidine group versus 70% in tramadol group. There was no significant difference for control (P = 0.5) and rate of recurrence of shivering between clonidine and tramadol group (06.7% vs. 16.7%; P = 0.42). Pulse rate and systolic blood pressure were significantly lower in clonidine group at 5 and 15 min as compared with tramadol. Significantly more number of patients experienced nausea and dizziness (36.7% vs. 0%; P < 0.001 and 20% vs. 0%; P = 0.01) with tramadol while bradycardia and hypotension were numerically more common in patients receiving clonidine (6.7% vs. 0% and 13.3% vs. 0%).

CONCLUSION:

Clonidine provides early relief from shivering than tramadol with fewer side effects in patients undergoing surgery under spinal anesthesia.

• Authors: Varsha Vyas, Rajat Gupta, Prakhar Dubey
• Journal: Anesthesia, essays and researches (Anesth Essays Res) 2018 Jul-Sep Vol. 12 Issue 3 Pg. 663-668 ISSN: 0259-1162 [Print] India
• PMID: 30283172 (Publication Type: Journal Article)