A Study of Dexmedetomidine, Tramadol and Pethidine in the Prevention of Intra Operative Shivering in Patients Undergoing Surgery under Spinal Anaesthesia

BACKGROUND : Shivering after spinal anaesthesia is a common occurrence. Incidence of shivering varies between 40 – 50%. Dexmedetomidine a relatively newer α 2 adrenergic agonist is effective against sedation. So, we compared the efficacy of this drug with time tested drugs, namely, pethidine and tramadol. AIM : To evaluate the efficacy of dexmedetomidine, tramadol and pethidine in the prevention of intra operative shivering in surgeries done under spinal anaesthesia. METHODS : A total of 90 American Society of Anaesthesiologists physical status I-II patients aged 18-65 years who were scheduled to undergo elective surgeries under spinal anaesthesia were enrolled in this study. Patients were randomly allocated into three groups and received dexmeditomidine (0.5mcg/kg; group A, n=30) in 100ml normal saline, tramadol (0.5mg/kg; group B, n=30) in 100ml normal saline or pethidine (0.5 mg/kg; group C, n=30) in 100ml normal saline intravenously over 10minutes immediately after administration of spinal anaesthesia. RESULTS : Among the study groups, dexmedetomidine was most effective in the prevention of shivering after the administration of spinal anaesthesia. P value of the study was 0.003 and was highly significant. Dexmedetomidine had higher sedation scores when compared with other two drugs and so, better comfort for the patients. Side profile of the three groups was similar and no statistically significant differences found between them. CONCLUSION : Dexmedetomidine is more effective in the prevention of shivering when compared with pethidine and tramadol. Dexmedetomidine has an added advantage of adequate reliable sedation. Pethidine is also equally effective in the prevention of shivering and is found to be more efficient than tramadol. Hence we conclude that Dexmedetomidine at 0.5μg/kg is most effective in the prevention of shivering when compared with pethidine and tramadol