Dr. Vadakkoot Raghavan Hema
BACKGROUND Shivering is an unpleasant complication of regional anaesthesia. Both tramadol and pethidine have been found to be effective in suppressing shivering. The aim of our study was to compare the efficacy of equipotent doses of tramadol and pethidine for control of shivering in patients undergoing spinal anaesthesia. MATERIALS AND METHODS A randomized double blind study was conducted on 60 patients undergoing Caesarean section who developed shivering during spinal anaesthesia. Approval was obtained from the Institutional Ethics Committee. The patients were randomly allocated to two groups of 30 each. Group T (n=30) received tramadol 0.5 mg/kg and Group P (n=30) received pethidine 0.5 mg/kg at the onset of shivering. The parturient was asked to assess the effect of treatment. The anaesthesiologist independently noted the time taken for shivering to subside. The degree of sedation and incidence of nausea and vomiting were also noted. The quantitative variables were compared using the unpaired t test and the qualitative variables using the Chi- Square test. RESULTS A total of 64% of patients in Group T and 86% in Group P noted improvement (P=0.003) at 5-minutes after drug administration. 43.3% in Group T had their shivering controlled compared to 83.3% in Group P (P=0.001) as assessed by the Anaesthesiologist. Sedation was more with pethidine than tramadol. The incidence of nausea was comparable, and no vomiting occurred in either group. CONCLUSION Pethidine 0.5 mg/kg is superior to tramadol 0.5 mg/kg when used for the control of intraoperative shivering under spinal anaesthesia though it can produce more sedation.