A Comparative Study between the Efficacy of Intravenous Tramadol and Intravenous Dexmedetomidine in Prevention of Shivering Following Subarachnoid Block

Abstract

Background: Shivering is a common complication following subarachnoid block (SAB), occurring in approximately 40–70% of patients. It increases oxygen consumption, carbon dioxide production, cardiac workload, and patient discomfort. Various pharmacological agents have been used for its prevention, among which tramadol and dexmedetomidine are commonly employed. This study was undertaken to compare the efficacy of intravenous tramadol and intravenous dexmedetomidine in preventing shivering following subarachnoid block.

Aim: To compare the efficacy of intravenous tramadol versus intravenous dexmedetomidine in the prevention of shivering following subarachnoid block.

Methods: This prospective, randomized, double-blind, controlled study was conducted in the Department of Anaesthesiology, Durgapur Steel Plant Hospital, West Bengal. Ninety ASA physical status I and II patients aged 18–50 years undergoing elective lower abdominal or lower limb surgeries under spinal anaesthesia were enrolled and randomized into two groups of 45 patients each.

Group A received intravenous tramadol 0.5 mg/kg diluted in 100 mL normal saline, while Group B received intravenous dexmedetomidine 0.5 mcg/kg diluted in 100 mL normal saline following SAB. Shivering score, onset, cessation time and duration of shivering, haemodynamic parameters, sedation score, and adverse effects were assessed at predefined intervals.

Results: The demographic characteristics of both groups were comparable. There was no statistically significant difference between the tramadol and dexmedetomidine groups regarding incidence, onset, cessation time, duration, or severity of shivering (p > 0.05). Haemodynamic parameters remained stable and comparable in both groups. However, patients receiving dexmedetomidine demonstrated significantly higher sedation scores without respiratory depression (p < 0.001).

The tramadol group showed a significantly higher incidence of nausea and vomiting compared with the dexmedetomidine group.

Conclusion: Both intravenous tramadol and intravenous dexmedetomidine are effective in preventing shivering following subarachnoid block. While their anti-shivering efficacy is comparable, dexmedetomidine provides superior sedation with fewer incidences of nausea and vomiting and without significant respiratory depression. Therefore, dexmedetomidine may be preferred when patient comfort and reduced adverse effects are desired, although cost and availability should also be considered.