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ORIGINAL ARTICLE
Year : 2018  |  Volume : 12  |  Issue : 3  |  Page : 663-668

Comparative efficacy and safety of intravenous clonidine and tramadol for control of postspinal anesthesia shivering


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

Correspondence Address:
Dr. Varsha Vyas
Department of Anaesthesia, D. Y. Patil School of Medicine and Hospital, Navi Mumbai, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aer.AER_86_18

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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.


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