Comparing the Effect of Intravenous Tramadol and Intravenous Nalbuphine in Addition to Midazolam for the Control of Shivering after Spinal Anesthesia

• Published in: Journal of pharmacology & pharmacotherapeutics Vol. 15; no. 3; pp. 264 - 276
• Main Authors: Madem, Apoorva, Parusha, Sravanthi, Mallem, Dinakar, Pacharla, Indira, Kotra, Vijay, Chooi, Wen Han, Wong, Rebecca Shin Yee, Ming, Long Chiau, Alkhoshaiban, Ali Saleh, Goh, Khang Wen
• Format: Journal Article
• Language: English
• Published: New Delhi, India SAGE Publications 01.09.2024; Sage Publications Ltd
• Subjects: Anesthesia; health risk; thermogenesis; anesthesiology; Clinical trial; human and disease; treatment outcome; body temperature regulation
• ISSN: 0976-500X; 0976-5018
• DOI: 10.1177/0976500X241262076

Introduction Shivering is a common complication during neuraxial anesthesia, leading to metabolic and cardiovascular challenges. Existing treatments vary in effectiveness, and this study compares intravenous tramadol and nalbuphine, both administered with midazolam, for shivering control. Objectives To evaluate and compare the efficacy of IV tramadol and IV nalbuphine, alongside midazolam, in controlling post-spinal anesthesia shivering. Materials and Methods A prospective, randomized comparative clinical study involving 100 patients undergoing various surgical procedures under spinal anesthesia. Patients were divided into two groups to receive either IV Tramadol or IV Nalbuphine with midazolam. Parameters like shivering severity, time to cessation, recurrence, and side effects were recorded and analyzed. Results Both tramadol and nalbuphine effectively controlled shivering with comparable response times and side effect profiles. There was no significant difference in the incidence of nausea, vomiting, and sedation between the groups. Hemodynamic stability was maintained throughout the study. Conclusion IV tramadol and IV nalbuphine, in conjunction with midazolam, are effective in controlling post-spinal anesthesia shivering, with similar efficacy and safety profiles. They provide valuable options for clinicians in managing this common anesthetic complication. Further research is encouraged for more refined application in diverse patient populations.