Comparing the Effect of Intravenous Tramadol and Intravenous Nalbuphine in Addition to Midazolam for the Control of Shivering after Spinal Anesthesia

Author:

Madem Apoorva1,Parusha Sravanthi1,Mallem Dinakar2,Pacharla Indira1,Kotra Vijay3,Chooi Wen Han4,Wong Rebecca Shin Yee5,Ming Long Chiau5ORCID,Alkhoshaiban Ali Saleh6,Goh Khang Wen7

Affiliation:

1. Department of Anesthesiology, MNJ Institute of Oncology & Research Centre for Cancer, Hyderabad, Telangana, India

2. Department of Forensic Medicine, Apollo Institute of Medical Sciences and Research, Hyderabad, Telangana, India

3. Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Quest International University, Ipoh, Perak, Malaysia

4. Department of Medicine, Faculty of Medicine, Quest International University, Ipoh, Perak, Malaysia

5. Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Sunway City, Malaysia

6. Pharmacy Practice Department, College of Pharmacy, Qassim University, Qassim University Medical City, Saudi Arabia

7. Department of Data Science, Faculty of Data Science and Information Technology, INTI International University, Nilai, Malaysia

Abstract

Introduction Shivering is a common complication during neuraxial anesthesia, leading to metabolic and cardiovascular challenges. Existing treatments vary in effectiveness, and this study compares intravenous tramadol and nalbuphine, both administered with midazolam, for shivering control. Objectives To evaluate and compare the efficacy of IV tramadol and IV nalbuphine, alongside midazolam, in controlling post-spinal anesthesia shivering. Materials and Methods A prospective, randomized comparative clinical study involving 100 patients undergoing various surgical procedures under spinal anesthesia. Patients were divided into two groups to receive either IV Tramadol or IV Nalbuphine with midazolam. Parameters like shivering severity, time to cessation, recurrence, and side effects were recorded and analyzed. Results Both tramadol and nalbuphine effectively controlled shivering with comparable response times and side effect profiles. There was no significant difference in the incidence of nausea, vomiting, and sedation between the groups. Hemodynamic stability was maintained throughout the study. Conclusion IV tramadol and IV nalbuphine, in conjunction with midazolam, are effective in controlling post-spinal anesthesia shivering, with similar efficacy and safety profiles. They provide valuable options for clinicians in managing this common anesthetic complication. Further research is encouraged for more refined application in diverse patient populations.

Publisher

SAGE Publications

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