title: A comparative study on the efficacy of dexmedetomidine and tramadol on post-spinal anesthesia shivering.
abstract: BACKGROUND
  Shivering is a common postanesthesia adverse event with multiple etiologies. At present tramadol is a widely used drug for the control of shivering. However, tramadol may cause a lot of nausea and vomiting. Hence, the need to find a better drug with less of side effects. The aim of this study was to compare the efficacy of dexmedetomidine and tramadol in the treatment of post-spinal anesthesia (SA) shivering as well as to compare their side-effect profile.
  
  
  METHODS
  This prospective, double-blind, randomized controlled trial was conducted in a tertiary care hospital. A total of 100 patients having shivering after SA were enrolled, out of which fifty received dexmedetomidine (Group A) and 50 received tramadol (Group B). The response rate, time to cessation of shivering and side effects (if any) was noted. All the results were analyzed using Student'st-test and Chi-square test.
  
  
  RESULTS
  All patients who received dexmedetomidine as well as tramadol had cessation of shivering. The time to cessation of shivering was significantly less with dexmedetomidine (174.12 ± 14.366 s) than with tramadol (277.06 ± 23.374 s) (P< 0.001). The recurrence rate of shivering with dexmedetomidine was less (6%) as compared to tramadol (16%). Nausea and vomiting was found to be higher in the case of tramadol. On the other hand, dexmedetomidine caused moderate sedation (modified Ramsay sedation score = 3-4) from which the patient could be easily awoken up.
  
  
  CONCLUSIONS
  Dexmedetomidine offers better results than tramadol with fewer side effects.
authors.affiliation: Department of Anaesthesia, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India.
authors.forename: Tanveer Singh
authors.initials: TS
authors.lastname: Kundra
authors.affiliation: Department of Anaesthesia and Critical Care, SPS Hospitals, Ludhiana, Punjab, India.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Kuthiala
authors.affiliation: Department of Anaesthesia and Critical Care, SPS Hospitals, Ludhiana, Punjab, India.
authors.forename: Anupam
authors.initials: A
authors.lastname: Shrivastava
authors.affiliation: Department of Anaesthesia, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India.
authors.forename: Parminder
authors.initials: P
authors.lastname: Kaur
keywords: Dexmedetomidine; postoperative nausea and vomiting; shivering; tramadol