Intrathecal Tramadol for prevention of shivering in Anorectal surgeries under Sub arachnoid anaesthesia
Abstract
Introduction: Shivering is very common problem during Sub arachnoid block (SAB), also known as Spinal anaesthesia. It can be prevented by intrathecal opioid injection.
Material and method: In our study we have included 50 patients scheduled for anorectal surgery. They all were given spinal anaesthesia with bupivacaine 12.5 mg along with injection Tramadol 10 mg and watched for initial 4 hour.
Result: 3 out of 50 patients showed shivering in treatment group who have received injection Tramadol.
Discussion: Probable mechanism of action is its activity at mu receptor and serotonin and nor epinephrine reuptake inhibition
Conclusion: Intrathecal Tramadol in dose of 10 mg prevents shivering in most of the patients. It can safely be used for prevention of shivering without significant side effect.
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References
2. Bhattacharya PK, Bhattacharya L, Jain RK, Agarwal RC. Post Anaesthesia Shivering: A Review. Indian J. Anaesthesia. 2003; 47 (2): 88-93.
3. Eberhart LH, Döderlein F, Eisenhardt G, Kranke P, Sessler DI, Torossian A, Wulf H, Morin AM. Independent Risk Factors for Postoperative Shivering. Anesth Analg. 2005 Dec;101(6):1849-57. [PubMed]
4. Morgan GE, Mikhail MS, Murray MJ. Clinical Anesthesiology: Lange Medical Books/McGraw Hill; 2006, 1008-9.
5. Alfonsi, P. Postanaesthetic shivering: epidemiology, pathophysiology, and approaches to prevention and management. Minerva Anestesiol. 2003 May;69(5):438-42. [PubMed]
6. Peter Kranke, Leopold H E, Norbert Roewer, Martin R. Trame. Pharmacological Treatment of Postoperative Shivering: A Quantitative Systematic Review of Randomised Controlled Trials. AnesthAnalg 2002; 24 : 453 – 60.
7. Crossley AW, Mahajan RP. The intensity of postoperative shivering is unrelated to axillary temperature. Anaesthesia. 1994;49:205–07. [PubMed]
8. CrowleyLJ, Buggy DL, Shivering and neuraxia l anaesthesia. Regional Anesthesia and Pain Medicine 2008; 33(3):241-52. [PubMed]
9. Ronald D miller ,Miller’s anesthesia,6th ed, Churchill living stone,(p1580).
10. Rang and dales Pharmacology,churchil livingstone,6th edi(p 605).
11. Goodman and gilman’s pharmacological basis for therapeutics,12th edi,p 1023.
12. Mohta M, Kumari N, Tyagi A, Sethi AK, Agarwal D, Singh MTramadol for prevention of postanaesthetic shivering: a randomised double-blind comparison with pethidine. Anaesthesia. 2009 Feb;64(2):141-6. [PubMed]
13. Ali Sadegh, Nasrin Faridi Tazeh-kand, Bita Eslami. Intrathecal fentanyl for the prevention of shivering in spinal anaesthesia in caesarean section. Med J Islam Repub Iran. May 2012; 26(2): 85–89. [PubMed]
14. Tewari A,dhawan I.etal “use of oral tramadol to prevent perianesthetic shivering in patients undergoing transurethral resection of prostate under subarachnoid blockade,”. saudi journal of Anaesthesia, 2014;8(1):11-16.
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