Abstract

Shivering is a biological reaction that occurs in response to a decrease in core body temperature, known as hypothermia, with the purpose of enhancing the production of metabolic heat. The occurrence of shivering during anesthesia can be attributed to the prolonged impairment of thermoregulatory autonomic function, as well as the combination of cool temperatures in the operating room and the administration of cold infusion fluids. Methods: This prospective study included 180 individuals who shivered under spinal anaesthesia during abdominal or orthopaedic surgery. On shivering, patients received a 1 mL intravenous bolus dose of 50 mg tramadol, 1 mg butorphanol, or 150 mcg clonidine. All 3 groups were compared for shivering control, time to cessation, recurrence, hemodynamic changes, axillary temperatures, and side effects. Data was processed using statistical methods. Results: The efficacy of butorphanol and tramadol in reducing shivering surpasses that of clonidine. The administration of butorphanol, tramadol, and clonidine resulted in a significant reduction in rigours among 83%, 73%, and 53% of the patients, respectively. The administration of clonidine resulted in a longer duration of action (3.3±0.9 minutes) compared to both butorphanol and tramadol (2.1±1.0 minutes and 1.8±0.5 minutes, respectively; p<0.001). Conclusion: The administration of butorphanol demonstrated superior efficacy in managing shivering, exhibiting a reduced frequency of recurrences compared to tramadol. However, both butorphanol and tramadol exhibited superior efficacy in comparison to clonidine, with the added benefit of an early onset of action. Both opioids are more effective than α-2 agonists in reducing rigors

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