Tewari Anurag, Dhawan Ira, Mahendru Vidhi, Katyal Sunil, Singh Avtar, Garg Shuchita
Department of Anesthesiology, Dayanand Medical College, Ludhiana, India.
Saudi J Anaesth. 2014 Jan;8(1):11-6. doi: 10.4103/1658-354X.125898.
Under regional anesthesia, geriatric patients are prone to shivering induced perioperative complications that Anesthesiologists should prevent rather than treat.
We investigated the prophylactic efficacy of oral tramadol 50 mg to prevent the perioperative shivering after transurethral resection of prostate (TURP) surgery under subarachnoid blockade (SAB). Shivering is usually overlooked in patients undergoing urological surgery under spinal anesthesia and may result in morbidity, prolonged hospital stay and increased financial burden. Use of prophylactic measures to reduce shivering in geriatric patients who undergo urological procedures could circumvent this. Oral formulation of tramadol is a universally available cost-effective drug with the minimal side-effects.
Prospective, randomized, double-blinded, placebo-controlled study.
A total of 80 patients who were scheduled for TURP surgery under subarachnoid block were randomly selected. Group I and II (n = 40 each) received oral tramadol 50 mg and placebo tablet respectively. After achieving subarachnoid block, the shivering, body temperature (tympanic membrane, axillary and forehead), hemodynamic parameters and arterial saturation were recorded at regular intervals.
T-test, analysis of variance test, Z-test and Fisher exact test were utilized while Statistical Product and Service Solutions, IBM, Chicago (SPSS statistics (version 16.0)), software was used for analysis.
Incidence of shivering was significantly less in patients who received tramadol (7.5% vs. 40%; P < 0.01). The use of tramadol was associated with clinically inconsequential side-effects.
We conclude that the use of oral tramadol 50 mg is effective as a prophylactic agent to reduce the incidence, severity and duration of perioperative shivering in patients undergoing TURP surgery under SAB.
在区域麻醉下，老年患者容易出现围手术期寒战相关并发症，麻醉医生应予以预防而非治疗。
我们研究了口服50毫克曲马多预防蛛网膜下腔阻滞（SAB）下经尿道前列腺切除术（TURP）术后围手术期寒战的疗效。在脊髓麻醉下接受泌尿外科手术的患者中，寒战通常被忽视，这可能导致发病、住院时间延长和经济负担增加。对接受泌尿外科手术的老年患者采取预防措施以减少寒战可以避免这种情况。曲马多的口服制剂是一种普遍可用、具有成本效益且副作用最小的药物。
前瞻性、随机、双盲、安慰剂对照研究。
总共随机选择80例计划在蛛网膜下腔阻滞下进行TURP手术的患者。第一组和第二组（每组n = 40）分别接受口服50毫克曲马多和安慰剂片。蛛网膜下腔阻滞成功后，定期记录寒战、体温（鼓膜、腋窝和额头）、血流动力学参数和动脉血氧饱和度。
采用t检验、方差分析、Z检验和Fisher精确检验，同时使用IBM公司芝加哥的统计产品与服务解决方案（SPSS统计软件（版本16.0））进行分析。
接受曲马多治疗的患者寒战发生率显著较低（7.5%对40%；P < 0.01）。曲马多的使用与临床上无关紧要的副作用相关。
我们得出结论，口服50毫克曲马多作为预防药物可有效降低蛛网膜下腔阻滞下接受TURP手术患者围手术期寒战发作的发生率、严重程度和持续时间。
