Comparison of Intravenous Dexmedetomidine and Tramadol for Post Spinal Anesthesia Shivering: A Randomized Controlled Study

Introduction: In patients undergoing neuraxial anesthesia, shivering is a normal thermoregulatory mechanism as evidenced by the presence of vasoconstriction before shivering. Spinal anesthesia impairs the thermoregulatory system by inhibiting vasoconstriction, which plays an important role in temperature regulation. Tramadol is a synthetic opioid. Many studies on tramadol showed its efficacy in the treatment of shivering. tramadol produces adverse effects like nausea, vomiting, dizziness etc. Which can create further discomfort to the patient. Dexmedetomidine is a selective alpha 2 adrenergic agonist and has 1600 times greater selectivity for the alpha 2 adrenergic receptor compared with alpha 1 receptor. It produces sedation, anxiolysis, hypnosis, analgesia, sympatholysis and has antishivering properties. we compared the anti-shivering effect of dexmedetomidine with that of tramadol after spinal anaesthesia. In addition to evaluating any side effect of such medication. Methodology: 120 ASA grade I and II patients, 20-60 years old, scheduled for surgeries under spinal anaesthesia were included in this study. The patients were randomly assigned to two groups, Group D received inj. Dexmedetomidine 0.5mcg/kg and Group T received inj. Tramadol 0.5mg/kg after onset of shivering. Time taken to stoppage of shivering and recurrence were noted. The incidence of adverse effects such as nausea, vomiting, headache, bradycardia, respiratory depression, and hypotension were recorded. Results: The two groups were comparable in demographic data. Time to stopaage of shivering was earlier and recurrence was less in Group D. Group D patients were more haemodynamicaly stable than Group T. Conclusion: Dexmedetomidine is more effective in the prevention of shivering when compared with tramadol. Dexmedetomidine has an added advantage of adequate reliable sedation.