Clonidine versus Tramadol for postanesthetic shivering: a randomized clinical trial study
DOI:
https://doi.org/10.15419/bmrat.v4i10.377Keywords:
Clonidine, Iran, Randomized clinical trial, Shivering, TramadolAbstract
Introduction: To compare the effects of oral clonidine and tramadol on shivering caused by spinal anesthesia in patients undergoing transurethral lithotripsy (TUL).
Methods: The present study is a triple-blind clinical trial conducted on 80 elective urologic surgical candidates during 2016-2017 at Tehran Hasheminejad Hospital in Iran. Using the Balanced Block Randomization method, the patients were randomly assigned into two groups (40 patients per group) 90 minutes before performing spinal anesthesia. The first group (group C) received 150 µg of oral clonidine and the second group (group T) received 50 mg of oral tramadol. Body temperature, core body temperature, heart rate, diastolic blood pressure and shivering were recorded for the patients at different time periods, and entered in the SPSS22 software program. The above variables were then statistically analyzed using independent sample T-tests chi-squared tests and Repeated Measure ANOVA.
Results: The results of this study indicated that there was a significant statistical difference (P<0.05) between the clonidine and tramadol treatment groups with regards to some variables, such as average body temperature and average core temperature, at different time periods. However, for other variables, such as heart rate, systolic blood pressure, diastolic blood pressure and shivering, there were no significant statistical differences between the two treatment groups (P>0.05).
Conclusion: Clonidine and tramadol treatment groups were only significantly different in terms of body temperature and core temperature. Therefore, it is recommended that other precise randomized clinical trials be performed to ensure the accuracy of the results of this study.
References
<li class="show">Alfonsi, P. (2003). Postanaesthetic shivering. Epidemiology, pathophysiology and approaches to prevention and management. Minerva Anestesiologica, 69(5), 438–442.<br>Attal, P., Chhaya, A., Singh, T., & Upadhayaya, R. (2015). Comparison of clonidine and tramadol for the control of shivering under spinal anaesthesia. International Journal of Biomedical and Advance Research, 6(1), 25–31. <a href="https://doi.org/10.7439/ijbar.v6i1.1492">https://doi.org/10.7439/ijbar.v6i1.1492</a></li>
<li class="show">Bilotta, F., Ferri, F., Giovannini, F., Pinto, G., & Rosa, G. (2005). Nefopam or clonidine in the pharmacologic prevention of shivering in patients undergoing conscious sedation for interventional neuroradiology. Anaesthesia, 60(2), 124–128. <a href="https://doi.org/10.1111/j.1365-2044.2004.04032.x">https://doi.org/10.1111/j.1365-2044.2004.04032.x</a></li>
<li class="show">Buggy, D., & Crossley, A. (2000). Thermoregulation, mild perioperative hypothermia and post-anaesthetic shivering. British Journal of Anaesthesia, 84(5), 615–628. <a href="https://doi.org/10.1093/bja/84.5.615">https://doi.org/10.1093/bja/84.5.615</a></li>
<li class="show">Crassous, P.-A., Denis, C., Paris, H., & Sénard, J. M. (2007). Interest of α2-adrenergic agonists and antagonists in clinical practice: Background, facts and perspectives. Current Topics in Medicinal Chemistry, 7(2), 187–194. <a href="https://doi.org/10.2174/156802607779318190">https://doi.org/10.2174/156802607779318190</a></li>
<li class="show">Davis, A. J., & Bissonnette, B. (1999). Thermal regulation and mild intraoperative hypothermia. Current Opinion in Anaesthesiology, 12(3), 303–309. <a href="https://doi.org/10.1097/00001503-199906000-00008">https://doi.org/10.1097/00001503-199906000-00008</a></li>
<li class="show">Davoudi, M., Mousavi-Bahar, S. H., & Farhanchi, A. (2009). Intrathecal meperidine for prevention of shivering during transurethral resection of prostate. Urology Journal, 4(4), 212–216.</li>
<li class="show">De Witte, J., & Sessler, D. I. (2002). Perioperative ShiveringPhysiology and Pharmacology. The Journal of the American Society of Anesthesiologists., 96(2), 467–484.</li>
<li class="show">Eberhart, L. H., Döderlein, F., Eisenhardt, G., Kranke, P., Sessler, D. I., Torossian, A., . . .. (2005). Independent risk factors for postoperative shivering. Anesthesia and Analgesia, 101(6), 1849–1857. <a href="https://doi.org/10.1213/01.ANE.0000184128.41795.FE">https://doi.org/10.1213/01.ANE.0000184128.41795.FE</a></li>
<li class="show">Hemmati, K., Derikvand, E., Delpisheh, A., & Safari, M. (2014). Comparison between effects of different doses of pethidine and fentanyl on shivering after spinal anesthesia in orthopedic patients referred to Imam Khomeini Hospital (RH) of Ilam. Anesthesiology and Pain., 4(4), 40–48.</li>
<li class="show">Honarmand, A., & Safavi, M. (2008). 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. British Journal of Anaesthesia, 101(4), 557–562. <a href="https://doi.org/10.1093/bja/aen205">https://doi.org/10.1093/bja/aen205</a></li>
<li class="show">Hoseinkhan, Z., & Behzadi, M. (2006). Morphine, Pethidine and Fentanyl in post-operative shivering control: A randomized clinical trial. Tehran University Medical Journal TUMS Publications., 64(12), 57–63.</li>
<li class="show">Khajavi, Mr., Shariat‐Moharari, R., Imani, F., & Etezadi, F. (2012). Evaluation of oral clonidine effects on prevention ofpost-anesthesia shivering. Anesthesiology and Pain., 2(7), 96–0.</li>
<li class="show">Kranke P, Eberhart LH, Roewer N, Tramèr MR. Postoperative shivering in children. Pediatric drugs. 2003;5(6):373-83. <a href="https://doi.org/10.2165/00128072-200305060-00003">https://doi.org/10.2165/00128072-200305060-00003</a></li>
<li class="show">Kranke, P., Eberhart, L. H., Roewer, N., & Tramèr, M. R. (2004). Single-dose parenteral pharmacological interventions for the prevention of postoperative shivering: A quantitative systematic review of randomized controlled trials. Anesthesia and Analgesia, 99(3), 718–727. <a href="https://doi.org/10.1213/01.ANE.0000130589.00098.CD">https://doi.org/10.1213/01.ANE.0000130589.00098.CD</a></li>
<li class="show">Macario, A., Weinger, M., Carney, S., & Kim, A. (1999). Which clinical anesthesia outcomes are important to avoid? The perspective of patients. Anesthesia and Analgesia, 89(3), 652.</li>
<li class="show">Moodi, Z., & Borjian, S. (2009). A survey on the effect of clonidine in prevention of shivering following general anesthesia. Journal of Birjand University of Medical Sciences., 16(2), 5–9.</li>
<li class="show">Panzer, O., Ghazanfari, N., Sessler, D. I., Yucel, Y., Greher, M., Akca, O., . . .. (1999). Shivering and shivering-like tremor during labor with and without epidural analgesia. The Journal of the American Society of Anesthesiologists., 90(6), 1609–1616.</li>
<li class="show">Pawar MS, Suri N, Kaul N, Lad S, Khan RM. Hydrocortisone reduces postoperative shivering following day care knee arthroscopy. Canadian Journal of Anesthesia/Journal canadien d'anesthésie. 2011;58(10):924. <a href="https://doi.org/10.1007/s12630-011-9566-7">https://doi.org/10.1007/s12630-011-9566-7</a></li>
<li class="show">Rafeie M, Hashemi S, DAVOUDABADI A, ADIB HM. The Study of Effects of Tramadol and Pethidine for Post Operative Shivering after Spinal Anesthesia for Inguinal Hernia Repair in Shahid Beheshti Hospital of Kashan During 18 Months. 2006.</li>
<li class="show">Reddy, V. S., & Chiruvella, S. (2011). Clonidine versus tramadol for post spinal shivering during caesarean section: A randomized double blind clinical study. Journal of Obstetric Anaesthesia and Critical Care, 1(1), 26.</li>
<li class="show">Tsai, Y.-C., & Chu, K.-S. (2001). A comparison of tramadol, amitriptyline, and meperidine for postepidural anesthetic shivering in parturients. Anesthesia and Analgesia, 93(5), 1288–1292. <a href="https://doi.org/10.1097/00000539-200111000-00052">https://doi.org/10.1097/00000539-200111000-00052</a></li>
<li class="show">Vanderstappen, I., Vandermeersch, E., Vanacker, B., Mattheussen, M., Herijgers, P., & Aken, H. (1996). The effect of prophylactic clonidine on postoperative shivering. Anaesthesia, 51(4), 351–355.<a href=" https://doi.org/10.1111/j.1365-2044.1996.tb07747.x"> https://doi.org/10.1111/j.1365-2044.1996.tb07747.x</a></li>
<li class="show">Wang, J.-J., Ho, S.-T., Lee, S.-C., & Liu, Y.-C. (1999). A comparison among nalbuphine, meperidine, and placebo for treating postanesthetic shivering. Anesthesia and Analgesia, 88(3), 686–689. <a href="https://doi.org/10.1213/00000539-199903000-00041">https://doi.org/10.1213/00000539-199903000-00041</a></li>
<li class="show">Wason, R., Jain, N., Gupta, P., & Gogia, A. R. (2012). Randomized double-blind comparison of prophylactic ketamine, clonidine and tramadol for the control of shivering under neuraxial anaesthesia. Indian Journal of Anaesthesia, 56(4), 370. <a href="https://doi.org/10.4103/0019-5049.100821">https://doi.org/10.4103/0019-5049.100821</a></li>
<li class="show">Yared, J.-P., Starr, N. J., Hoffman-Hogg, L., Bashour, C. A., Insler, S. R., O’connor, M., . . .. (1998). Dexamethasone decreases the incidence of shivering after cardiac surgery: A randomized, double-blind, placebo-controlled study. Anesthesia and Analgesia, 87(4), 795–799.</li>
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