Jibon Kumar Paul1, Abdul Jalil Barbhuiya2, Sayeedur Rahman3,
Parimol Kishore Dev4, Mriganka Bahattacharjee5
Parimol Kishore Dev4, Mriganka Bahattacharjee5
1. Assistant Professor, Department of Anesthesiology, North East Medical College, Sylhet.
2. Professor & Head, Department of Anesthesiology, North East Medical College Sylhet.
3. Assistant Professor, Department of Anesthesiology, North East Medical College Sylhet.
4. Assistant Professor, Department of Anesthesiology, Jalalabad Ragib-Rabeya Medical College, Sylhet.
5. Assistant Professor, Department of Anesthesiology, Jalalabad Ragib-Rabeya Medical College, Sylhet.
Abstract
Shivering is a common problem faced by an anesthesiologist during intraoperative as well as in postoperative period. It is a frequent, unpleasant, and undesirable complication occurring after sub-arachnoid block (SAB), secondary to vasodilatation as a result of sympathetic blockade. The incidence of shivering has been reported to be about 36-60% after SAB. The present study was designed to compare the efficacy of pethidine and tramadol on reducing postoperative shivering following sub-arachnoid block and to compare their adverse effect. This randomized, experimental study was conducted in patients undergoing surgery under sub-arachnoid block over a three months period. Patients were randomized into Group P (receiving pethidine) or Group T (receiving tramadol). Patients received either tramadol or pethidine in a dose of 0.5mg/kg intravenously after the appearance of shivering. Disappearance of shivering as well as hemodynamics was observed at scheduled intervals. Shivering score was significantly lower in Group P at 10, 15, 20, and 30 min compared to Group T.
Similarly, nausea/vomiting and dizziness were also lower in Group P but sedation score was higher. Pethidine provide better anti shivering effect than tramadol with less side effect in terms of nausea and vomiting but more sedation. Tramadol has less response rate and recurrence. It is cheap as compared to pethidine and freely available without drug license.
Key Words: Shivering, Sub-arachnoid block, Pethidine, Tramadol