oa Southern African Journal of Anaesthesia and Analgesia - Comparison of dexmedetomidine, pethidine and tramadol in the treatment of post-neuraxial anaesthesia shivering : research

Volume 21, Issue 1
  • ISSN : 2220-1181
  • E-ISSN: 2220-1173



This study was performed to compare the effectiveness of intravenous dexmedetomidine with that of pethidine and tramadol in the treatment of post-neuraxial anaesthesia shivering.

This was a prospective, randomised, double-blinded study.
One hundred and two patients of both genders, aged 18-70 years with American Society of Anesthesiologists physical status I and II undergoing spinal or combined spinal and epidural anaesthesia for elective surgery were enrolled in this study. Sixty of them developed shivering after an intrathecal injection of 0.5% hyperbaric bupivacaine 15 mg. They were then randomly allocated to receive either intravenous dexmedetomidine 0.5 µg/kg, pethidine 0.5 mg/kg or tramadol 0.5 mg/kg.
The response rate to treatment, the degree of sedation and the side-effects were recorded.
The response rate to treatment was highest in the dexmedetomidine group, and it was only significant when compared to tramadol group ( = 0.0012). It was noted that the response rate was higher in the pethidine than in the tramadol group. This difference was not statistically significant ( = 0.082). The sedation score post treatment was similar in all three groups, but more patients in the dexmedetomidine group developed hypotension and bradycardia ( < 0.05).
Dexmedetomidine 0.5 µg/ml was more effective than tramadol 0.5 mg/ml and pethidine 0.5 mg/ml, and both tramadol and pethidine were found to have similar efficacy, in the treatment of post-neuraxial anaesthesia shivering. However, dexmedetomidine caused a higher incidence of hypotension and bradycardia.

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