A Randomized Clinical Trial Comparing the Efficacy of Intravenous Dexmedetomidine and Tramadol in Preventing Shivering in Patients Undergoing Elective Surgeries with Subarachnoid Block (Code-T0290)

Introduction: Post-spinal anesthesia shivering (PSAS) is a common complication following neuraxial anesthesia, with an incidence of 40-70%. It can cause patient discomfort, increased oxygen consumption, and interfere with monitoring. Various pharmacological agents, including tramadol and dexmedetomidine, have been used to manage PSAS, but comparative studies are limited.

Aims and Objectives

“To compare the efficacy and safety of intravenous dexmedetomidine and tramadol for prevention of post spinal anaesthesia shivering”

Objectives of the study:

1. To compare the incidence of shivering
2. To compare severity of shivering
3. To compare rescue treatment required
4. To compare haemodynamic parameters
5. To compare sedation scores
6. To compare adverse effects if any

Methods: A total of 90 patients undergoing elective surgeries under spinal anesthesia were randomly assigned into three groups: Group D (dexmedetomidine 0.5 mcg/kg IV), Group T (tramadol 1 mg/kg IV), and Group C (placebo). The incidence, severity, and time to onset of shivering were recorded. Hemodynamic parameters, sedation scores, and adverse effects were also assessed. Statistical analysis was performed using ANOVA, with a p-value of <0.05 considered significant.

Results: Dexmedetomidine significantly reduced the incidence and severity of shivering compared to tramadol and placebo (p < 0.05). The time to onset of shivering was delayed in Group D. Hemodynamic stability was maintained in both treatment groups, though dexmedetomidine showed higher sedation scores. Tramadol was associated with a higher incidence of nausea and vomiting.

Conclusion: Dexmedetomidine is more effective than tramadol in preventing post-spinal anesthesia shivering, with better sedation and fewer adverse effects. It can be considered a preferable agent for shivering prophylaxis in neuraxial anesthesia.

Keywords: Dexmedetomidine, Tramadol, Shivering, Spinal Anesthesia, Hemodynamics, Sedation