Comparison of intrathecal tramadol and Magnesium sulphate for the prevention of post-spinal shivering in infra umbilical surgeries: A randomized, double blinded and controlled study

Abstract

: Post anesthesia shivering is a common complication after spinal anesthesia. Intrathecal Magnesium sulphate (MgSO4) and tramadol are the most effective and safe adjuvants with minimal side effects. The aim of this study was to compare the effect of intrathecal tramadol versus intrathecal MgSO4 with bupivacaine for the prevention of post-spinal anesthesia shivering. : In this prospective randomized, double-blinded controlled study, 105 patients scheduled for infraumbilical surgeries were randomly allocated into three groups. Group C(35) received 3.0ml of hyperbaric bupivacaine 0.5% (15mg)+0.5ml of normal saline, Group T (35) received 3.0ml of hyperbaric bupivacaine 0.5% (15mg)+25mg of tramadol in 0.5ml saline, and Group M (35) received 3.0ml of hyperbaric bupivacaine 0.5% (15mg)+100mg of magnesium sulphate in 0.5ml saline. The primary outcomes were to find the incidence and intensity of shivering. The secondary outcome was to find out the incidence of complications.: All the 3 groups were comparable with respect to demographic characteristics. Shivering was observed in 68.6% of the patients in Group C, 48.6% patients in Group T and 40% patients in Group M. The incidence of shivering were statistically significant between Groups C and T (P= 0.003) and Groups C and M (P=0.001) but not between Groups T and M (P=0.480). The incidence of complications such as hypotension, bradycardia, nausea, vomiting,itching and respiratory depression were not statistically significant in between the groups.: This study concluded that both intrathecal MgSO4 100mg and tramadol 25mg with hyperbaric bupivacaine reduces the incidence and intensity of shivering compared to control group after spinal anesthesia.