Effect of intravenous tramadol versus pethidine on postspinal shivering control among mothers during cesarean section at Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia: a prospective observational cohort study

Abstract

Background: Postspinal anesthesia shivering is a common complication during spinal anesthesia. It is very unpleasant and physiologically stressful for patients and challenging for healthcare providers. Shivering could be treated with tramadol or pethidine. However, the comparative effectiveness of one drug over the other drug has not been proven with a low-drug setup. Objective: To compare the effect of intravenous tramadol versus pethidine on postspinal shivering control among obstetric mothers who underwent cesarean section. Methods and materials: A prospective cohort study design was conducted on 180 ASA (American Society of Anesthesiology) I and II obstetric mothers. A systematic random sampling method was employed. Data were entered into EpiData version 4.6 and exported into SPSS version 25 for analysis. The independent sample t test was used to compare the difference of means between groups for normally distributed data, and the Mann–Whitney U test was used for non-normally distributed data. Categorical data were analyzed using the chi-squared test. Data were presented by mean±standard deviation for normally distributed data and median and interquartile range for non-normally distributed data. Categorical data were presented as numbers and frequencies. P values less than 0.05 were considered statistically significant. Results: One hundred eighty participants were used for analysis. The mean time of shivering disappearance was 5.5±1.75 min and 6.6±2.08 min in tramadol and pethidine groups, respectively (P<0.001). The hemodynamic changes were all comparable between the two groups. The difference in the recurrence of shivering after treatment was significant between the groups (P<0.001). Sedation was higher in the pethidine group, 9 (10%), than in the tramadol group, 2 (2.2%). Nausea and vomiting were found to be higher in the tramadol group, 10 (11.1%), than in the pethidine group, 5 (5.6%). Conclusions: Tramadol controlled shivering early, and recurrence of shivering and incidence of sedation were also low in the tramadol group. Therefore, tramadol is as effective as pethidine for the treatment of postspinal shivering in obstetric mothers who underwent cesarean delivery. So tramadol can be used as an alternative for postspinal shivering in obstetric mothers.