Prophylactic Tramadol versus Dexmedetomidine for Prevention of Shivering during Spinal Anaesthesia

Introduction: Shivering is a frequent and distressing complication of spinal anesthesia. It is not only unpleasant to the patient but also delays recovery by increasing oxygen consumption and aggravating pain. Aim: To compare tramadol and dexmedetomidine in prevention of shivering during spinal anesthesia and also to compare their adverse reactions. Patients and Methods: 60 American Society of Anesthesiologists I and II adults undergoing lower limb surgeries under spinal anesthesia were allocated into Group T and Group D, who received intravenous (IV) tramadol 1 mg/kg and IV dexmedetomidine 0.5 μg/kg respectively 5 min prior to subarachnoid block. Perioperative incidence and grade of shivering, level of sedation, hemodynamic parameters, and adverse reactions like pruritus, nausea/vomiting were recorded. Results: The incidence of shivering was highest at 30 min, 60 min in Group T (6.6%), and at 120 min in Group D (10%). But there was no statistically signifi cant difference between the incidence of shivering in the two groups at any point in time. Intraoperative sedation scores were signifi cantly higher in Group D at 30 min and in Group T at 45 min till the post-operative period. The incidence of side effects was lower in Group D. Conclusion: Dexmedetomidine may emerge as an alternative to tramadol for prophylaxis of postspinal shivering in short duration cases, with a better sedation profi le and fewer adverse effects.