title: Use of oral tramadol to prevent perianesthetic shivering in patients undergoing transurethral resection of prostate under subarachnoid blockade.
abstract: BACKGROUND
  Under regional anesthesia, geriatric patients are prone to shivering induced perioperative complications that Anesthesiologists should prevent rather than treat.
  
  
  OBJECTIVE
  We investigated the prophylactic efficacy of oral tramadol 50 mg to prevent the perioperative shivering after transurethral resection of prostate (TURP) surgery under subarachnoid blockade (SAB). Shivering is usually overlooked in patients undergoing urological surgery under spinal anesthesia and may result in morbidity, prolonged hospital stay and increased financial burden. Use of prophylactic measures to reduce shivering in geriatric patients who undergo urological procedures could circumvent this. Oral formulation of tramadol is a universally available cost-effective drug with the minimal side-effects.
  
  
  METHODS
  Prospective, randomized, double-blinded, placebo-controlled study.
  
  
  METHODS
  A total of 80 patients who were scheduled for TURP surgery under subarachnoid block were randomly selected. Group I and II (n = 40 each) received oral tramadol 50 mg and placebo tablet respectively. After achieving subarachnoid block, the shivering, body temperature (tympanic membrane, axillary and forehead), hemodynamic parameters and arterial saturation were recorded at regular intervals.
  
  
  METHODS
  T-test, analysis of variance test, Z-test and Fisher exact test were utilized while Statistical Product and Service Solutions, IBM, Chicago (SPSS statistics (version 16.0)), software was used for analysis.
  
  
  RESULTS
  Incidence of shivering was significantly less in patients who received tramadol (7.5% vs. 40%; P < 0.01). The use of tramadol was associated with clinically inconsequential side-effects.
  
  
  CONCLUSIONS
  We conclude that the use of oral tramadol 50 mg is effective as a prophylactic agent to reduce the incidence, severity and duration of perioperative shivering in patients undergoing TURP surgery under SAB.
authors.affiliation: Department of Anesthesiology, Dayanand Medical College, Ludhiana, India.
authors.forename: Anurag
authors.initials: A
authors.lastname: Tewari
authors.affiliation: Department of Anesthesiology, Dayanand Medical College, Ludhiana, India.
authors.forename: Ira
authors.initials: I
authors.lastname: Dhawan
authors.affiliation: Department of Anesthesiology, Dayanand Medical College, Ludhiana, India.
authors.forename: Vidhi
authors.initials: V
authors.lastname: Mahendru
authors.affiliation: Department of Anesthesiology, Dayanand Medical College, Ludhiana, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Katyal
authors.affiliation: Department of Anesthesiology, Dayanand Medical College, Ludhiana, India.
authors.forename: Avtar
authors.initials: A
authors.lastname: Singh
authors.affiliation: Department of Anesthesiology, Dayanand Medical College, Ludhiana, India.
authors.forename: Shuchita
authors.initials: S
authors.lastname: Garg
keywords: Shivering; subarachnoid blockade; tramadol; transurethral resection of prostate; urology