Study Of Intavenous Dexamethasone Versus Tramadol For The Prevention Of Shivering In Patients Undergoing General Anaesthesia

Abstract

Background: Postoperative shivering is a common experience for patients operated under general anaesthesia (GA). The reasons for shivering include: reduction in the vasoconstriction threshold, redistribution of the temperature from the core to the peripheral tissues and peripheral vasodilation caused by anaesthetic drugs. The incidence of post anaesthetic shivering (PAS) has been reported to range from 60-75% in patients recovering from GA. Objective Of The Study: The objective of the study is to compare the efficacy of dexamethasone and tramadol in the treatment of post-general anaesthesia (GA) shivering as well as to compare their side-effect profile. Methods: We included a total of 180 patients who were undergoing surgery under general anaesthesia. These patients were randomly allocated into three groups by the computer-generated Group number (D/T/S) which was put in a closed opaque envelope. Nursing staff (person not related to study), anaesthesia nurse was asked to open the closed envelope containing computer
generated group number on start of shivering in the patient. She prepared the drug in 10 ml syringe and sent it for use without labelling which drug it was, but she kept a record of the same. The study drug was prepared as a 10-mL solution in a syringe by a person not involved in the study. Both the patient and the person who was conducting the case, administering the study drug and observing the patient for the outcome measures in the post-operative period were blinded to the group allocation. Group D: Dexamethasone 0.1 mg/kg diluted with NS upto 10 mL, Group T: Tramadol 1 mg/kg diluted with NS upto 10 mL and Group S: normal saline 10 mL. Results: In this study, which was done on patients undergoing elective surgery under general anaesthesia, the drugs of tramadol, dexamethasone, and placebo were used and their effects on the prevention and control of postoperative shivering were evaluated. We found that the incidence of shivering was significantly lower in Dexamethasone group compared to Tramadol and placebo group. Similarly, the incidence of PONV was lower in Dexamethasone group compared to Group T and Group S. Conclusions: In the present study, we found that the incidence of shivering was significantly lower in Dexamethasone group compared to Tramadol and placebo group. Similarly, the incidence of PONV was lower in Dexamethasone group compared to Group T and Group S. This study shows that the dexamethasone is beneficial, as it is holding both properties (anti-shivering and antiemetic), so it is better to prefer dexamethasone over tramadol in prevention of shivering and PONV.