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Prevention of Shivering during Spinal Anesthesia: Comparison between Tramadol, Ketamine and Ondansetron.
JNMA J Nepal Med Assoc. 2017 Oct-Dec; 56(208):395-400.JJ

Abstract

INTRODUCTION

Shivering is an unpleasant experience after spinal anesthesia. We conducted this study to evaluate the efficacy of ondansetron, ketamine and tramadol for prevention of shivering.

METHODS

In this randomized controlled study, 120 patients aged 18-65 years of American Society of Anesthesiologist (ASA) physical status I and II undergoing various surgical procedures were included and allocated alternately to one of the 4 groups; Normal saline (Group1), Ondansetron 4mg (Group2), Ketamine 0.25mg/kg (Group3) and Tramadol 0.5mg/kg (Group4). Incidence of shivering, effect on hemodynamics, nausea, vomiting, sedation and emergence reactions were recorded. Data was analyzed using SPSS (The Statistical Package for Social Sciences) version 20.0 software.

RESULTS

The patients were comparable in terms of demographic variables, baseline temperature, type of surgery, median level of sensory blockade, duration of surgery and anesthesia. Shivering was present in 17 (56.7%), 5 (16.7%), 3 (10%) and 3 (10%) patients respectively in Group 1, 2, 3 and 4 which was statistically significant when compared to Group 1 (P=0.00) The odds of NS and ondansetron, NS and ketamine, NS and tramadol was 6.53, 11.76 and 11.76 respectively which showed that study drugs were effective in preventing shivering. None of the patients were sedated in Group 1 and 2. Mild to moderate sedation was present in Group 3 and 4 (P=0.00). None of the patients had drug related adverse reactions.

CONCLUSIONS

Prophylactic use of ondansetron, low doses of ketamine and tramadol is effective in preventing shivering post spinal anesthesia without untoward effects.

Authors+Show Affiliations

Department of Anesthesia, Manipal College of Medical Sciences, Phulbari-11, Pokhara, Nepal.Department of Anesthesia, Manipal College of Medical Sciences, Phulbari-11, Pokhara, Nepal.Department of Anesthesia, Manipal College of Medical Sciences, Phulbari-11, Pokhara, Nepal.Department of Anesthesia, Manipal College of Medical Sciences, Phulbari-11, Pokhara, Nepal.Department of Anesthesia, Manipal College of Medical Sciences, Phulbari-11, Pokhara, Nepal.Department of Anesthesia, Manipal College of Medical Sciences, Phulbari-11, Pokhara, Nepal.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

29453468

Citation

Lakhe, Gajal, et al. "Prevention of Shivering During Spinal Anesthesia: Comparison Between Tramadol, Ketamine and Ondansetron." JNMA; Journal of the Nepal Medical Association, vol. 56, no. 208, 2017, pp. 395-400.
Lakhe G, Adhikari KM, Khatri K, et al. Prevention of Shivering during Spinal Anesthesia: Comparison between Tramadol, Ketamine and Ondansetron. JNMA J Nepal Med Assoc. 2017;56(208):395-400.
Lakhe, G., Adhikari, K. M., Khatri, K., Maharjan, A., Bajracharya, A., & Khanal, H. (2017). Prevention of Shivering during Spinal Anesthesia: Comparison between Tramadol, Ketamine and Ondansetron. JNMA; Journal of the Nepal Medical Association, 56(208), 395-400.
Lakhe G, et al. Prevention of Shivering During Spinal Anesthesia: Comparison Between Tramadol, Ketamine and Ondansetron. JNMA J Nepal Med Assoc. 2017 Oct-Dec;56(208):395-400. PubMed PMID: 29453468.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevention of Shivering during Spinal Anesthesia: Comparison between Tramadol, Ketamine and Ondansetron. AU - Lakhe,Gajal, AU - Adhikari,Krishna Murari, AU - Khatri,Kiran, AU - Maharjan,Anil, AU - Bajracharya,Akriti, AU - Khanal,Himdip, PY - 2018/2/18/entrez PY - 2018/2/18/pubmed PY - 2019/3/13/medline KW - Anesthesia spinal; Ketamine; Ondansetron; Shivering; Tramadol. SP - 395 EP - 400 JF - JNMA; journal of the Nepal Medical Association JO - JNMA J Nepal Med Assoc VL - 56 IS - 208 N2 - INTRODUCTION: Shivering is an unpleasant experience after spinal anesthesia. We conducted this study to evaluate the efficacy of ondansetron, ketamine and tramadol for prevention of shivering. METHODS: In this randomized controlled study, 120 patients aged 18-65 years of American Society of Anesthesiologist (ASA) physical status I and II undergoing various surgical procedures were included and allocated alternately to one of the 4 groups; Normal saline (Group1), Ondansetron 4mg (Group2), Ketamine 0.25mg/kg (Group3) and Tramadol 0.5mg/kg (Group4). Incidence of shivering, effect on hemodynamics, nausea, vomiting, sedation and emergence reactions were recorded. Data was analyzed using SPSS (The Statistical Package for Social Sciences) version 20.0 software. RESULTS: The patients were comparable in terms of demographic variables, baseline temperature, type of surgery, median level of sensory blockade, duration of surgery and anesthesia. Shivering was present in 17 (56.7%), 5 (16.7%), 3 (10%) and 3 (10%) patients respectively in Group 1, 2, 3 and 4 which was statistically significant when compared to Group 1 (P=0.00) The odds of NS and ondansetron, NS and ketamine, NS and tramadol was 6.53, 11.76 and 11.76 respectively which showed that study drugs were effective in preventing shivering. None of the patients were sedated in Group 1 and 2. Mild to moderate sedation was present in Group 3 and 4 (P=0.00). None of the patients had drug related adverse reactions. CONCLUSIONS: Prophylactic use of ondansetron, low doses of ketamine and tramadol is effective in preventing shivering post spinal anesthesia without untoward effects. SN - 0028-2715 UR - https://www.unboundmedicine.com/medline/citation/29453468/Prevention_of_Shivering_during_Spinal_Anesthesia:_Comparison_between_Tramadol_Ketamine_and_Ondansetron_ DB - PRIME DP - Unbound Medicine ER -