Muhammad Azam, Naila Asad, Tanvir Akhtar Butt, Waseem Ahmad.
Efficacy of Prophylactic Intravenous Ketamine Vs Tramadol for Prevention of Intraoperative Shivering in Spinal Anesthesia for patient undergoing cesarean section.
Pak J Med Health Sci Jan ;12(2):455-8.

Background: Shivering is a frequently occurring complication of spinal anaesthesia . It is more common in patients undergoing abdomen surgery, procedures of long duration and extremes of age . It has deleterious consequences on patient recovery unless prophylactic steps are taken to prevent this complication. Aim: To compare the prophylactic use of I/V tramadol with I/V ketamine on the frequency of intraoperative shivering in spinal anesthesia for patients undergoing cesarean section. Methods: A prospective randomized study was conducted in 400 parturients of ASA I and II status undergoing cesarean section. They were randomly divided into two groups n=200 each. Patients received prophylactic i/v 0.5mg Ketamine (K Group) and 2mg/kg i/v tramadol (T Group). Spinal anaesthesia was administered with injection bupivacaine. After assessment of adequacy of block, frequency of shivering was recorded. Results: In this study of 400 patients, shivering was seen in 111 patients (27.75%) . Shivering was seen not observed in 289(72.25%) patients. Frequency of shivering was seen in 72(36%) patients of tramadol group and 39 (19.5%) from ketamine group. This difference in two groups was statistically significant (P value 0.000). Conclusion: It has been proved in our study that the use of prophylactic i/v low dose 0.5mg/kg Ketamine drug is significantly more effective as compared to i/v tramadol in the prevention of intraoperative shivering during spinal anesthesia in females undergoing cesarean section.

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