Treatment of postanesthetic shivering in children: A randomized control study comparing tramadol to pethidine

Post-anaesthetic shivering (PAS) is a common and distressing complication, with most studies conducted in adults (Kranker et al., 2003). The aim of this study was to compare the effectiveness of tramadol and pethidine in the treatment of PAS in children. A randomized, double blind, comparative study was carried out on 80 children of American Society of Anesthesiologists (ASA) physical status I or II who presented with PAS during recovery from general anaesthesia. The children were randomized to receive 0.4 mg/kg of either drug. The response to treatment was assessed in 5, 15, 30, 45 and 60 min. The mean time [SD] for cessation of shivering following treatment with tramadol was 5.57 min (0.8) while with pethidine cessation occurred after 7.42 min (0.94), which was statistically significant. However, 17 patients in the pethidine group developed significant side effects when compared with the 4 patients in the tramadol group. Finally, there was a 10% recurrence of PAS with tramadol as against 50% with pethidine after 45 min. Both regimens were effective in treating PAS, but tramadol had a quicker onset time, with less side effects and recurrence rates of PAS. Key words: Shivering, anaesthesia, pethidine, tramadol.