Abstract
Post-anaesthetic shivering (PAS) is a common and distressing complication, with most studies conducted in adults (Kranker et al., 2003). The aim of this study was to compare the effectiveness of tramadol and pethidine in the treatment of PAS in children. A randomized, double blind, comparative study was carried out on 80 children of American Society of Anesthesiologists (ASA) physical status I or II who presented with PAS during recovery from general anaesthesia. The children were randomized to receive 0.4 mg/kg of either drug. The response to treatment was assessed in 5, 15, 30, 45 and 60 min. The mean time [SD] for cessation of shivering following treatment with tramadol was 5.57 min (0.8) while with pethidine cessation occurred after 7.42 min (0.94), which was statistically significant. However, 17 patients in the pethidine group developed significant side effects when compared with the 4 patients in the tramadol group. Finally, there was a 10% recurrence of PAS with tramadol as against 50% with pethidine after 45 min. Both regimens were effective in treating PAS, but tramadol had a quicker onset time, with less side effects and recurrence rates of PAS. Key words: Shivering, anaesthesia, pethidine, tramadol.
Highlights
Post-anaesthetic shivering (PAS) is common in the postoperative period and varies according to gender, age, and the duration for the surgery (Buggy et al, 1997; Piper et al, 2004; Macario et al, 1997; Powell and Buggy, 2000)
Several pharmacological agents have been studied for the treatment of PAS, including clonidine, ketamine, doxapram, tramadol, and pethidine (Kranker et al, 2002; Piper et al, 2000; Alfonsi, 2001)
Eighty patients were enrolled into the study (40 in each group) comprising 53 males and 27 females
Summary
Post-anaesthetic shivering (PAS) is common in the postoperative period and varies according to gender, age, and the duration for the surgery (Buggy et al, 1997; Piper et al, 2004; Macario et al, 1997; Powell and Buggy, 2000). Several pharmacological agents have been studied for the treatment of PAS, including clonidine, ketamine, doxapram, tramadol, and pethidine (Kranker et al, 2002; Piper et al, 2000; Alfonsi, 2001). Among these agents, pethidine and tramadol have been widely used, in the treatment of PAS (Dhimar et al, 2007; Bhatnagar et al, 2001; Seifi et al, 2008). Previous studies have shown varied results regarding its effectiveness in treating PAS in adults (Zahedi, 2004; Tsai and Chu, 2001). Previous studies have shown varied results regarding its effectiveness in treating PAS in adults (Zahedi, 2004; Tsai and Chu, 2001). Akin et al (2005)
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