Assessment of Post¬ anesthetic shivering by using Ketamine and Tramadol: A randomized controlled trial
Abstract
Aim: To assess the Post-anesthetic shivering by using Ketamine and Tramadol in cases of lower limb surgery which demands the use of spinal anesthesia.
Study design: A randomized controlled trial
Place and duration: This study was conducted at Jhalwan Medical College Khuzdar, Pakistan from January 2020 to June 2020
Methodology: The study population was between the ages of 18 to 60 years. The study was inclusive to both genders and divided into 2 categories: Group 1 and group 2. The patients were allocated to each group randomly where the first group included patients being treated with an injection of tramadol 0.5 mg/kg to treat post -anesthetic shivering (PAS). The second group consisted of patients being injected with ketamine in a dose of 0.25 mg/kg added with Tramadol 0.25 mg/kg to treat their post -anesthetic shivering (PAS). Each patient was asked rate their shivering and the shivering was graded on a scale of 1 to 5 where a positive label was shared if the grade was between 2 to 5. Study also noted the time of shivering for each patient after the administration of the spinal anesthesia. Any complications from the administration of the drugs were also recorded such as bradycardia , hypotension , nausea , vomiting .
Results: The study had total of 200 patients with 100 patients belonging to each group. Their ASA classifications was 1 and 2 noted, and the perioperative vitals were compared along with the demographic characteristics. The frequency off shivering was much slower in group 2 then it was in group one. The time of onset of shivering was noted for both groups where it showed that group one patients started shivering before group two and lasted for 23.11 + 1.7 minutes, whereas group two patients started shivering later and lasted for 34.5 +2.5 minutes where the P-value was concluded to be less than 0.05. The frequency of shivering was calculated and shown as 62.6% for group 2 as compared to the 86.3% of group 1. The complications from the administration of the drugs where shown to be less in group 2 and it was noted that group one had more patients who suffered from complications such as bradycardia, hypotension, vomiting, and nausea.
Conclusion: From this study it can be considered that the use of ketamine in low doses when added with tramadol bruce to be more effective in helping post anesthetic shivering as compared to the administration of tramadol alone under spinal anesthesia.