Comparison of clonidine and tramadol for the control of shivering under spinal anaesthesia

Abstract

Objectives - This study aimed to evaluate the relative efficacy of intravenously administered clonidine and tramadol for control of intraoperative shivering following spinal anaesthesia. Materials and Methods - A prospective, randomized, clinical controlled study was conducted on 60 ASA grade-I &II patients of either sex, aged 18-40 years, scheduled for elective lower abdominal and lower limb surgeries, under spinal anaesthesia. Patients who developed post spinal intraoperative shivering of grades 3 or 4, lasting for minimum period of  2minutes were included in the study, and randomly allocated to one of the two groups, group C (n=30), received Inj. clonidine 50µg i.v., and group T (n=30),  received Inj. tramadol 50mg i.v. when shivering was observed. Time taken for control of shivering, response rate, recurrence rate, and side effects were observed. Results - The response rate was significantly higher in tramadol group than clonidine group at 1min, 2mins, 3mins and 5mins intervals and comparable in both groups at 15 mins.  The average time taken for disappearance of shivering was higher in clonidine group i.e. 5.76 ± 0.88mins as against 3.16 ± 0.84mins in tramadol group (P=0.038). Patients with incomplete response and recurrence were more in clonidine group. Side effects like hypotension, bradycardia, sedation and dry mouth were observed in clonidine group patients,  and nausea and vomiting in tramadol group, but were controllable. Conclusion -Tramadol is better as compared to  clonidine for control of intraoperative shivering under spinal anaesthesia due to  rapid onset, higher response rate, lesser recurrence, lesser sedation and lesser hemodynamic alterations.