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Comparative Efficacy and Safety of Intravenous Clonidine and Tramadol for Control of Postspinal Anesthesia Shivering.
Anesth Essays Res. 2018 Jul-Sep; 12(3):663-668.AE

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+Show Affiliations

Department of Anesthesia, D. Y. Patil School of Medicine and Hospital, Navi Mumbai, Maharashtra, India.Department of Anesthesia, VMMC and Safdarjung Hospital, New Delhi, India.Department of Anesthesia, D. Y. Patil School of Medicine and Hospital, Navi Mumbai, Maharashtra, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30283172

Citation

Vyas, Varsha, et al. "Comparative Efficacy and Safety of Intravenous Clonidine and Tramadol for Control of Postspinal Anesthesia Shivering." Anesthesia, Essays and Researches, vol. 12, no. 3, 2018, pp. 663-668.
Vyas V, Gupta R, Dubey P. Comparative Efficacy and Safety of Intravenous Clonidine and Tramadol for Control of Postspinal Anesthesia Shivering. Anesthesia, essays and researches. 2018;12(3):663-668.
Vyas, V., Gupta, R., & Dubey, P. (2018). Comparative Efficacy and Safety of Intravenous Clonidine and Tramadol for Control of Postspinal Anesthesia Shivering. Anesthesia, Essays and Researches, 12(3), 663-668. https://doi.org/10.4103/aer.AER_86_18
Vyas V, Gupta R, Dubey P. Comparative Efficacy and Safety of Intravenous Clonidine and Tramadol for Control of Postspinal Anesthesia Shivering. Anesthesia, essays and researches. 2018 Jul-Sep;12(3):663-668. PubMed PMID: 30283172.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative Efficacy and Safety of Intravenous Clonidine and Tramadol for Control of Postspinal Anesthesia Shivering. AU - Vyas,Varsha, AU - Gupta,Rajat, AU - Dubey,Prakhar, PY - 2018/10/5/entrez PY - 2018/10/5/pubmed PY - 2018/10/5/medline KW - Clonidine KW - postspinal anesthesia shivering KW - tramadol SP - 663 EP - 668 JF - Anesthesia, essays and researches VL - 12 IS - 3 N2 - 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. SN - 0259-1162 UR - https://www.unboundmedicine.com/medline/citation/30283172/Comparative_Efficacy_and_Safety_of_Intravenous_Clonidine_and_Tramadol_for_Control_of_Postspinal_Anesthesia_Shivering_ L2 - http://www.aeronline.org/article.asp?issn=0259-1162;year=2018;volume=12;issue=3;spage=663;epage=668;aulast=Vyas DB - PRIME DP - Unbound Medicine ER -
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