Comparative Study Between Tramadol Hydrochloride and Pethidine for Control of Shivering Under Regional Anaesthesia in Obstetric Patients

Authors

  • Ayub Ali Specialist, Dept. of Anaesthesiology, Square Hospitals Ltd. Dhaka
  • Ibrahim Khalilullah Registrar & Specialist, Dept. of Cardiac Anaesthesiology, Ibrahim Cardiac Hospital & Research Institute,
  • Debashish Das Specialist, Dept. of Anaesthesiology, Square Hospitals Ltd. Dhaka
  • Md Ariful Hoque Specialist,, Dept. of Anaesthesiology, Square Hospitals Ltd. Dhaka,
  • Basudeb Das Specialist, Dept. of Anaesthesiology, Square Hospitals Ltd. Dhaka
  • Md Tarikul Hasan Specialist, Dept. of Anaesthesiology, Square Hospitals Ltd. Dhaka
  • Rafiqul Hasan Khan Associate Professor, Dept. of Anaesthesiology, Bangladesh Medical College Hospital,
  • Kamal Ibrahim Professor & Head, Dept. of Anaesthesiology, Bangladesh Medical College Hospital

DOI:

https://doi.org/10.3329/jbsa.v32i2.66865

Keywords:

Shivering,Regional Anesthesia, Tramadol Hcl, Pethidine.

Abstract

Background: Shivering is a common complication observed in post spinal anaesthesia. It can be veryunpleasant and physiologically stressful for the patients. Different drugs are used for prevention andtreatment of post spinal shivering.

Materials & Methods: This prospective, randomized, double blinded, comparative clinical study wasconducted in the department of Anaesthesioloy, Bangladesh Medical College Hospital, Dhanmondi,Dhaka from 1st June ‘2016 to 30th November 2016. This study was designed to evaluate the efficacy andside effects of tramadol hydrochloride comparing with pethidine in the treatment of shivering of pregnantpatients underwent cesarean section under spinal anaesthesia. Total 160 ASA grade-l & ll pregnantpatients of cesarean section under Sub arachnoid block, who shivered, were included in this study.Patients were randomly allocated into two groups. Group-T (n=80) received tramadol hydrochloride1mg/kg and Group-P (n= 80) received pethidine 0.5mg/kg body weight intravenously for treatment ofshivering and side effects were recorded and subsequently analyzed.

Results: Disappearance of shivering after treatment was significantly earlier in Group-T (3.09±0.86minutes) than in Group-P ((5.11±1.08 minutes) (p <0.01). Recurrence of shivering after treatment wassignificantly less in Group-T 2(2.5%) than Group-P 7(8.75%) (p<0.01). Adverse effects were significantlyhigher in Group-P than Group-T. Nausea in 5(6.25%) patients and vomiting in 4(5%) patients found inGroup-P and nausea in 1(1.25%) patients and vomiting in 1(1.25%) patient found in Group-T. Differenceswere statistically significant in case of nausea (p<0.01) and vomiting (p<0.01). Dizziness and pruritusobserved in no patient of Group-T and in Group-P dizziness observed in 5(6.25%) patients and pruritusobserved in 4(5%). Differences were statistically significant in case of dizziness (p<0.001) & pruritus(p<0.001).

Conclusion: Both tramadol hydrochloride and pethidine effectively controlled shivering in patientsduring cesarean section under spinal anaesthesia, but tramadol hydrochloride offered rapid onset, lessrecurrence, and fewer side effects when compared to pethidine in obstetric patients.

JBSA 2019; 32(2): 44-49

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Published

2019-07-31

How to Cite

Ali, A. ., Khalilullah, I. ., Das, D. ., Hoque, M. A. ., Das, B. ., Hasan, M. T. ., Khan, R. H. ., & Ibrahim, K. . (2019). Comparative Study Between Tramadol Hydrochloride and Pethidine for Control of Shivering Under Regional Anaesthesia in Obstetric Patients. Journal of the Bangladesh Society of Anaesthesiologists, 32(2), 77–82. https://doi.org/10.3329/jbsa.v32i2.66865

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Original Articles