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[A prospective, randomized, double-blinded control study on comparison of tramadol, clonidine and dexmedetomidine for post spinal anesthesia shivering].
Rev Bras Anestesiol. 2018 Jan - Feb; 68(1):42-48.RB

Abstract

INTRODUCTION

Shivering, a common intraoperative problem under spinal anesthesia increases the oxygen consumption considerably and is uncomfortable and distressing to the patient, anesthesiologist as well as surgeon. The present study was designed to explore the effectiveness of tramadol, clonidine and dexmedetomidine in the treatment of post spinal anesthesia shivering and to look for their adverse effects.

METHODS

This prospective, randomized, double blinded control study was done on 90 patients who developed shivering under spinal anesthesia. They were randomly allocated into three groups with Group T receiving tramadol 1mg.kg-1, Group C getting clonidine 1mcg.kg-1 and Group D patients receiving dexmedetomidine 0.5mcg.kg-1. The time taken to control shivering, recurrence rate, hemodynamic variables, sedation score and adverse effects were observed.

RESULTS

Dexmedetomidine was faster in the control of shivering in 5.7±0.79minutes (min) whereas tramadol took 6.76±0.93min and clonidine was slower with 9.43±0.93min. The recurrence rate was much lower in the dexmedetomidine group with 3.3% than for clonidine (10%) and tramadol (23.3%) group. The sedation achieved with dexmedetomidine was better than clonidine and tramadol. The tramadol group had more cases of vomiting (four) and dexmedetomidine group had six cases of hypotension and two cases of bradycardia. Two of the clonidine patients encountered bradycardia and hypotension.

CONCLUSION

Dexmedetomidine is better than tramadol and clonidine in the control of shivering because of its faster onset and less recurrence rate. Though complications are encountered in the dexmedetomidine group, they are treatable.

Authors+Show Affiliations

SRM Medical College Hospital and Research Centre, Department of Anesthesia, Chennai, India. Electronic address: drvenkat94@gmail.com.SRM Medical College Hospital and Research Centre, Department of Anesthesia, Chennai, India.SRM Medical College Hospital and Research Centre, Department of Anesthesia, Chennai, India.SRM Medical College Hospital and Research Centre, Department of Anesthesia, Chennai, India.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

por

PubMed ID

28546012

Citation

Venkatraman, Rajagopalan, et al. "[A Prospective, Randomized, Double-blinded Control Study On Comparison of Tramadol, Clonidine and Dexmedetomidine for Post Spinal Anesthesia Shivering]." Revista Brasileira De Anestesiologia, vol. 68, no. 1, 2018, pp. 42-48.
Venkatraman R, Karthik K, Pushparani A, et al. [A prospective, randomized, double-blinded control study on comparison of tramadol, clonidine and dexmedetomidine for post spinal anesthesia shivering]. Rev Bras Anestesiol. 2018;68(1):42-48.
Venkatraman, R., Karthik, K., Pushparani, A., & Mahalakshmi, A. (2018). [A prospective, randomized, double-blinded control study on comparison of tramadol, clonidine and dexmedetomidine for post spinal anesthesia shivering]. Revista Brasileira De Anestesiologia, 68(1), 42-48. https://doi.org/10.1016/j.bjan.2017.04.019
Venkatraman R, et al. [A Prospective, Randomized, Double-blinded Control Study On Comparison of Tramadol, Clonidine and Dexmedetomidine for Post Spinal Anesthesia Shivering]. Rev Bras Anestesiol. 2018 Jan - Feb;68(1):42-48. PubMed PMID: 28546012.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [A prospective, randomized, double-blinded control study on comparison of tramadol, clonidine and dexmedetomidine for post spinal anesthesia shivering]. AU - Venkatraman,Rajagopalan, AU - Karthik,Krishnamoorthy, AU - Pushparani,Anand, AU - Mahalakshmi,Annadurai, Y1 - 2017/05/22/ PY - 2016/03/07/received PY - 2016/08/02/accepted PY - 2017/5/27/pubmed PY - 2019/6/14/medline PY - 2017/5/27/entrez KW - Clonidina KW - Clonidine KW - Dexmedetomidina KW - Dexmedetomidine KW - Hipotermia KW - Hypothermia KW - Raquianestesia KW - Shivering KW - Spinal anesthesia KW - Tramadol KW - Tremor SP - 42 EP - 48 JF - Revista brasileira de anestesiologia JO - Rev Bras Anestesiol VL - 68 IS - 1 N2 - INTRODUCTION: Shivering, a common intraoperative problem under spinal anesthesia increases the oxygen consumption considerably and is uncomfortable and distressing to the patient, anesthesiologist as well as surgeon. The present study was designed to explore the effectiveness of tramadol, clonidine and dexmedetomidine in the treatment of post spinal anesthesia shivering and to look for their adverse effects. METHODS: This prospective, randomized, double blinded control study was done on 90 patients who developed shivering under spinal anesthesia. They were randomly allocated into three groups with Group T receiving tramadol 1mg.kg-1, Group C getting clonidine 1mcg.kg-1 and Group D patients receiving dexmedetomidine 0.5mcg.kg-1. The time taken to control shivering, recurrence rate, hemodynamic variables, sedation score and adverse effects were observed. RESULTS: Dexmedetomidine was faster in the control of shivering in 5.7±0.79minutes (min) whereas tramadol took 6.76±0.93min and clonidine was slower with 9.43±0.93min. The recurrence rate was much lower in the dexmedetomidine group with 3.3% than for clonidine (10%) and tramadol (23.3%) group. The sedation achieved with dexmedetomidine was better than clonidine and tramadol. The tramadol group had more cases of vomiting (four) and dexmedetomidine group had six cases of hypotension and two cases of bradycardia. Two of the clonidine patients encountered bradycardia and hypotension. CONCLUSION: Dexmedetomidine is better than tramadol and clonidine in the control of shivering because of its faster onset and less recurrence rate. Though complications are encountered in the dexmedetomidine group, they are treatable. SN - 1806-907X UR - https://www.unboundmedicine.com/medline/citation/28546012/[A_prospective_randomized_double_blinded_control_study_on_comparison_of_tramadol_clonidine_and_dexmedetomidine_for_post_spinal_anesthesia_shivering]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0034-7094(17)30269-6 DB - PRIME DP - Unbound Medicine ER -