Zia Uddin Ahmed, Muhammad Abdul Aziz, Sahira Nawaz Khan, Mahnoor Zia.
Comparative study of Tramadol versus Ketamine for Postoperative Shivering.
Pak J Med Health Sci Jan ;12(4):1348-50.

Background: Regional anesthesia may impair thermoregulatory control and results in of shivering in patients undergoing surgery in regional anesthesia. Shivering increases metabolic rate and oxygen consumption. Certain medical methods are used in preventing shivering . Aim : To compare the frequency of intra operative shivering with intravenous tramadol and ketamine in patients undergoing infra-umbilical surgery under spinal anaesthesia. Study Design: Randomized Clinical Trial . Setting : Operation Theatres, Jinnah Hospital Lahore. Duration: 6 Months . Data Collection Procedure: 200 cases were enrolled and divided randomly in 2 groups. In group "T", Tramadol 1mg /kg was infused and in group "K", Ketamine 0.5mg/ kg was infused 5 min earlier spinal anesthesia. All patients were examined for shivering by using four point scale after 15, 30, 45, 60 mins. Results : The mean age in Group T was 32.12+/- 9.30 years and in Group K was 33.37 +/-9.40 years. (P = 0.068). At 60 min after spinal anesthesia, in Group T, shivering was observed 6(6%) of patients where as in Group K, it was observed in 32.0% (n=32) of patients. (P = 0.001). Conclusion : Frequency of intra operative shivering with intravenous tramadol is less than ketamine in patient undergoing infra-umbilical surgery under spinal anaesthesia .

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