Efficacy of Tramadol vs Pethidine for Control of Anaesthesia Induced Shivering in Patients undergoing Elective Caesarian Section under Spinal Anaesthesia

Authors

  • Syed Asad Ali Department of Anesthesia, Combined Military Hospital Zhob/National University of Medical Sciences (NUMS) Pakistan
  • Muhammad Ahmed Khan Department of Anesthesia, Combined Military Hospital Zhob/National University of Medical Sciences (NUMS) Pakistan
  • Sumera Akram Mardan Medical Complex, Mardan Pakistan
  • Hassan Ibrahim Combined Military Hospital Rawalakot/National University of Medical Sciences (NUMS) Pakistan
  • Arif Mahmood Combined Military Hospital Rawalakot/National University of Medical Sciences (NUMS) Pakistan
  • Akhtar Ali Combined Military Hospital Rawalakot/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75iSUPPL-6.6148

Keywords:

Anaesthesia Induced Shivering, Ceasarian Section, Pethidine, Spinal Anaesthesia, Tramadol

Abstract

Objective: To determine the effectiveness of tramadol for control of Anaesthesia Induced Shivering and compare it with pethidine in elective caesarian section patients under spinal anaesthesia.

Study Design: Quasi-experimental study

Place and Duration of Study: Main Operation Theatre, SKBZ/ Combined Military Hospital, Rawalakot Pakistan, from Jan to Jun 2020.

Methodology: After approval from the ethical review committee of the Hospital and taking patient’s informed consent, 60 patients who developed grade 2 or 3 shivering after induction of spinal anesthesia were allocated to two group A & group B alternatively. Group A received IV tramadol 1mg/kg whereas Group B received IV pethidine 0.5mg/kg. SPSS version 21 was used to analyze the data and calculate mean and standard.

Results: Anaesthesia induced shivering was effectively controlled in 86.66% (n=26) participants in Tramadol Group versus 83.33% (n=25) participants in Pethidine Group, p-value was calculated as 0.0001 which was significant.

Conclusion: Tramadol is an acceptable, easily available, as well as a safer alternative to pethidine for control of anaesthesia induced shivering in patients having elective caesarean section under spinal anaesthesia.

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References

1. Albergaria VF, Lorentz MN, Lima FAS. Intra- and postoperative tremors: prevention and pharmacological treatment. Rev Bras Anesthesiol 2007; 57: 431-444.

2. Tolani KA, Bendo AA. Prevention and treatment of homeostatic disorders after central neurological procedures. Best Pract Res Clin Anaesthesiol 2007; 21: 539-556.

3. Mohammadi FH, Khajavi MR, Imani F, Azodi SS, Tavakoli B, Khashayar P. Tramadol and meperidine effect in postanaesthetic shivering. Recent Advances in Clinical Medicine 2010: 127-135.

4. Talakoub R, Meshkati SN. Tramadol versus meperidine in the treatment of shivering during spinal anesthesia in cesarean section. JRMS 2006; 11(3): 151-155.

5. Sagir O, Gulhas N, Toprak H. Control of shivering during regional anaesthesia: prophylactic ketamine and granisetron. Acta Anaesthesiol Scand 2007; 51: 44-49.

6. Honarmand A, Safavi MR. Comparison of prophylactic use of midazolam, ketamine, and ketamine plus midazolam for prevention of shivering during regional anaesthesia: a randomized double-blind placebo controlled trial. Br J Anaesth 2008; 101: 557–562.

7. Nicholau, D. The postanesthesia care unit. In: Miller RD, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Young WL, editors. Miller's Anesthesia. 7th ed. Philadelphia, PA: Churchill Livingstone 2010: 2707-2728.

8. Mohta M, Kumari N, Tyagi A, Sethi AK, Agarwal D, Singh M. Tramadol for prevention of postanaesthetic shivering: a randomised double-blind comparison with pethidine. Anaesthesia 2009; 64(2): 141-146.

9. Charuluxananan S, Trakulthong C, Areejunthawa J. Pharmacological treatment of post-anesthetic shivering: A systematic review and meta-analysis. Asian Biomedicine 2009; 3(4): 351-363.

10. Dhimar A, Patel M, Swadia V. Tramadol for control of shivering (Comparison with pethidine). Indian J Anaesth 2007; 51(1): 28.

11. Bhatnagar S, Saxena A, Kannan TR, Punj J, Panigraphi M, Mishra S. Tramadol for postoperative shivering : a double-blind comparision with pethidine. Anaesth intensive care 2001; 29(2): 149-154.

12. Zhang Y, Wong KC, Anesthesia and postoperative shivering: its etiology, treatment and prevention. Acta Anaesthesiol Sin 1999; 37(3): 115-120.

13. Tilahun A, Seifu A, Aregawi A, Abera B, Demsie DG. Effectiveness of meperidine versus tramadol on post spinal anesthesia shivering in elective cesarean section: A prospective observational cohort study. International Journal of Surgery Open 2021; 28: 22-26.

14. Jayaraj A, Balachander H, Kuppusamy SK, Arusamy S, Rai Y, Siddiqui N. Comparison of meperidine, tramadol and fentanyl for post-spinal shivering prevention during cesarean delivery: A double-blind randomized controlled trial. The journal of obstetrics and gynaecology research 2019; 45(11): 2202-2208.

15. Wahid, F., Hussain, A., & Rehman, F. (2019). Comparison of Tramadol and Pethidine for the treatment of shivering during spinal anesthesia. Journal of Rawalpindi Medical College 2019; 23(3): 148-152.

16. Yaakop AF, Hassan MH, Omar SC, Mazlan MZ, Mumkin LA, Hassan WNW. Tramadol vs. pethidine to control perioperative shivering in cesarean section under spinal anesthesia: a double-blind study. Anaesthesia, Pain & Intensive care 2022; 26(3).

17. Lema GF, Gebreegziabher E, Gebremedhn, Gebregzi AH, Desta YT, Kassa AA. Efficacy of intravenous tramadol and low-dose ketamine in the prevention of post-spinal anesthesia shivering following cesarean section: a double-blinded, randomized control trial. International Journal of Women’s Health 2017; 9: 681-688.

18. Tarkkila P, Tuominen M, Lindgren L. Comparision of respiratory effects of tramadol and pethidine. Eur J Anaesthesiol 1998; 15(1): 64-68.

19. Mathews S, Al Mulla A, Radim K, Mumtaz S. Post-anaesthetic shivering-a new look at tramadol anaesthesia 2002; 57(4): 394-398.

20. Wahid F, Hussain A, Rehman F. Comparison of Tramadol and Pethidine for the treatment of shivering during spinal anesthesia. J Rawal Med Coll 2019; 23(3): 148-152.

21. Fern L, Misiran K. Comparison of Dexmedetomidine, Pethidine and Tramadol in the treatment of post-neuraxial anesthesia shivering. South afr J Anaesth Analg 2015; 21(1): 14-18

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Published

30-09-2025

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Original Articles

How to Cite

1.
Ali SA, Khan MA, Akram S, Ibrahim H, Mahmood A, Ali A. Efficacy of Tramadol vs Pethidine for Control of Anaesthesia Induced Shivering in Patients undergoing Elective Caesarian Section under Spinal Anaesthesia. Pak Armed Forces Med J [Internet]. 2025 Sep. 30 [cited 2025 Oct. 6];75(SUPPL-6):S846-S850. Available from: https://pafmj.org/PAFMJ/article/view/6148