Kundra Tanveer Singh, Kuthiala Gaurav, Shrivastava Anupam, Kaur Parminder
Department of Anaesthesia, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India.
Department of Anaesthesia and Critical Care, SPS Hospitals, Ludhiana, Punjab, India.
Saudi J Anaesth. 2017 Jan-Mar;11(1):2-8. doi: 10.4103/1658-354X.197344.
Shivering is a common postanesthesia adverse event with multiple etiologies. At present tramadol is a widely used drug for the control of shivering. However, tramadol may cause a lot of nausea and vomiting. Hence, the need to find a better drug with less of side effects. The aim of this study was to compare the efficacy of dexmedetomidine and tramadol in the treatment of post-spinal anesthesia (SA) shivering as well as to compare their side-effect profile.
This prospective, double-blind, randomized controlled trial was conducted in a tertiary care hospital. A total of 100 patients having shivering after SA were enrolled, out of which fifty received dexmedetomidine (Group A) and 50 received tramadol (Group B). The response rate, time to cessation of shivering and side effects (if any) was noted. All the results were analyzed using Student's -test and Chi-square test.
All patients who received dexmedetomidine as well as tramadol had cessation of shivering. The time to cessation of shivering was significantly less with dexmedetomidine (174.12 ± 14.366 s) than with tramadol (277.06 ± 23.374 s) ( < 0.001). The recurrence rate of shivering with dexmedetomidine was less (6%) as compared to tramadol (16%). Nausea and vomiting was found to be higher in the case of tramadol. On the other hand, dexmedetomidine caused moderate sedation (modified Ramsay sedation score = 3-4) from which the patient could be easily awoken up.
Dexmedetomidine offers better results than tramadol with fewer side effects.
寒战是一种常见的麻醉后不良事件，病因多样。目前，曲马多是一种广泛用于控制寒战的药物。然而，曲马多可能会引起大量恶心和呕吐。因此，需要找到一种副作用更少的更好药物。本研究的目的是比较右美托咪定和曲马多治疗腰麻后寒战的疗效，并比较它们的副作用情况。
这项前瞻性、双盲、随机对照试验在一家三级护理医院进行。共有100例腰麻后出现寒战的患者入组，其中50例接受右美托咪定（A组），50例接受曲马多（B组）。记录反应率、寒战停止时间和副作用（如有）。所有结果均采用学生t检验和卡方检验进行分析。
所有接受右美托咪定和曲马多治疗的患者寒战均停止。右美托咪定组寒战停止时间（174.12±14.366秒）明显短于曲马多组（277.06±23.374秒）（P<0.001）。右美托咪定组寒战复发率（6%）低于曲马多组（16%）。曲马多组恶心和呕吐发生率更高。另一方面，右美托咪定引起中度镇静（改良Ramsay镇静评分=3-4），患者可轻易唤醒。
右美托咪定比曲马多效果更好，副作用更少。
