DOI: 10.36347/sjams.2015.v03i08.017

Pages: 2826-2829

Spinal anesthesia is known to significantly impair thermoregulation through inhibiting vasomotor and shivering responses and through redistributing heat from core body to peripheral tissues with subsequent rapid hypothermia during anesthesia. Among pharmacological therapies a recent meta-analysis, reported use of Clonidine, Tramadol, pethidine, nefopam and ketamine as the most common agents. There are few studies from this region comparing Cloniidne and Tramadol, hence the present study. This was a open label randomized study conducted in a tertiary care hospital in South India, from June 2014 to November 2014. The participants were allocated to receive Clonidine (Group C; n = 40) or Tramadol (Group T; n=40). Group C (n=40) received Clonidine 0.5 µg/kg (intravenously) IV, and group T (n=40) received Tramadol 0.5 mg/kg IV. Patients who developed grade 3 or 4 shivering for at least 3 minutes after spinal anesthesia were included in the study. Student's T test has been used to find the significance of study parameters between two groups of patients, Chisquare/ 2x3 Fisher Exact test has been used to find the significance of study parameters on categorical scale between two or more groups. In the present study, it was observed that both Clonidine and Tramadol are effective in treating post spinal shivering, but the time interval from the commencement of treatment to cessation of shivering is quite less with Clonidine (P<0.01). The response rate was 100% in Clonidine group and recurrence was nil. Complications like hypotension, bradycardia, and dry mouth were observed in Clonidine group and nausea and vomiting in Tramadol group. The sedation score was higher in Clonidine group. Both Clonidine and Tramadol are effective in treating patients with post-spinal anesthesia shivering. The higher incidence of side effects of tramadol, like nausea, vomiting and dizziness, may limit its use as an anti-shivering drug.