Abstract

ABSTRACT
Background and objectives
Post-anesthetic shivering (PAS) is a common complication following general and regional anesthesia. It is important to identify the centrally-acting analgesic drugs that effectively prevent and treat shivering with fewer side effects than other opioid agonists. Our study aims to compare the effect of prophylactic use of intravenous tramadol versus low dose ketamine plus tramadol for the prevention of shivering under spinal anesthesia.
Setting
Department of Anesthesiology, Surgical ICU and Pain Management, Civil hospital Karachi (CHK)
Duration of Study
Six months (from 01-05-2016 to 31-10-2016)
Study Design
Randomized controlled trial study.

Subjects and methods
All patients with ages between 18 to 50 years of both genders presented with American Society of Anesthesiologist physical status I and II having inguinal hernia surgeries diagnosed clinically were included. The patients were randomly allocated to group T (tramadol 0.5mg/kg) and Group KT (ketamine 0.25 mg/Kg plus Tramadol 0.25mg/Kg). Shivering was labeled as positive if the grade founds to be 2-5. Time to shivering was noted in minutes from the administration of spinal anesthesia to onset shivering. Perioperative complication such as nausea vomiting hypotension and bradycardia were also recorded
Results
Demographic characteristics, ASA classification, and perioperative vitals of both groups were comparable (p-value >0.05). Patients in group KT had lesser cases of shivering with 65(68.4%) as compared to group T in which 81(85.2%) cases of shivering were noted (p value< 0.05 ).
Group T had earlier onset of shivering than group KT with 24.01±1.9 minutes and 33.1±2.8 minutes respectively (p-value

Key words: Intravenous tramadol, Ketamine, Shivering, Spinal Anesthesia