Tramadol In Patients Research Articles

Comparison of Post-Operative Pain with Diclofenac Rectal Suppository vs Intravenous Tramadol in Patients Undergoing Inguinal Hernioplasty

Background: Pain is a highly intricate and distressing sensation that is subjective. There is uncertainty observed in the selection of optimal methods for intra and post-operative administration of analgesics for inguinal hernia repair surgery. Objective: To compare the mean postoperative pain score in diclofenac rectal suppositories with intravenous tramadol in patients undergoing inguinal hernioplasty. Study Design: Randomized control trial. Settings: Department of Surgery, Allied Hospital, Faisalabad Pakistan. Duration: From November 25, 2022 to May 25, 2023. Methods: After approval of the ethical board, patients from OPD / emergency were enrolled. All the patients undergo inguinal hernioplasty under regional anesthesia. In group A, patients received diclofenac rectal suppository 100 mg, and in group B, patients received intravenous tramadol 100 mg. The visual analog scale was explained to the patients. Pain was assessed after the 2nd, 6th, and 12th hour of hernioplasty. All the information noted on proforma. Results: Comparison of the mean post-operative pain score shows 3.67 ± 0.48 in Group A and 2.40 ± 0.50 in Group B at 2 hours, p-value 0.000, 3.64 ± 0.49 in Group A and 3.43 ± 0.50 in Group B at 6th Hour, p-value was 0.605, 3.30 ± 0.47 in Group A and 4.0 ± 0.79 in Group B at 12th hour, p-value=0.000. Conclusion: We concluded that diclofenac rectal suppository is significantly better than intravenous tramadol in patients undergoing inguinal hernioplasty in terms of mean postoperative pain score.

Antishivering effect of intrathecal versus intravenous tramadol in patients undergoing urethroscopic lithotripsy under spinal anesthesia

Background: Shivering is the most common complication seen in the perioperative period in patients undergoing urological surgeries under spinal anesthesia. Intravenous tramadol is used for the treatment of shivering. Aims and Objectives: In this study, we wanted to assess the prophylactic effect of tramadol, intrathecal (IT) versus intravenous with the control group, in decreasing the incidence of shivering. Materials and Methods: Fifty-four eligible patients posted for urethroscopic lithotripsy (URSL) were randomly allocated into three equal groups – Group C: Received 2.5 mL 0.5% bupivacaine heavy + 0.5 mL normal saline intrathecally and 5 mL of normal saline intravenously, Group V: Received 2.5 mL of 0.5% bupivacaine heavy+0.5 mL normal saline intrathecally and 25 mg tramadol in 5 mL of normal saline intravenously, and Group T: Received 2.5 mL of 0.5% bupivacaine heavy + 25 mg (0.5 mL) of tramadol intrathecally and 5 mL of normal saline intravenously. The incidence and severity of shivering were noted. Onset of sensory and motor block, duration of post-operative analgesia, core body temperature, and adverse effects such as nausea, vomiting, and hypotension were noted. Results: The incidence of intraoperative shivering was significantly lower in Group T versus C (P=0.014) but comparable among Group I versus C (P=0.502) and Group T versus I (P=0.06). The duration of analgesia was significantly higher in Group T compared to Groups I and C (P<0.001). The additional tramadol requirement was significantly lower in Group T versus I and in Group T versus C but comparable among Group I versus C. Conclusion: The addition of 25 mg tramadol to IT 0.5% bupivacaine heavy is effective in preventing intraoperative shivering in patients undergoing urological surgeries like URSL.

Impact of CYP2D6 and CYP2B6 phenotypes on the response to tramadol in patients with acute post-surgical pain.

Tramadol is an important minor opioid prescribed for pain management. In this study, we analyzed the well-known impact of CYP2D6 genetic variation and 60 additional variants in eight candidate genes (i.e., ABCG2, SLCO1B1, CYP2D6, CYP2B6, CYP2C19, CYP2C9, CYP3A5, and CYP3A4) on tramadol efficacy and safety. Some 108 patients with pain after surgery admitted to a post-anesthesia care unit (PACU) and prescribed tramadol were recruited. They were genotyped, and tramadol M1/M2 metabolite concentrations were determined by a newly validated HPLC-MS/MS method. CYP2D6 intermediate (IM) and poor (PM) metabolizers showed lower M1 concentrations adjusted for dose/weight at 30 and 120 min compared to ultrarapid (UM) and normal (NM) metabolizers (univariate p < 0.001 and 0.020, multivariate p < 0.001 and 0.001, unstandardized β coefficients = 0.386 and 0.346, R2 = 0.146 and 0.120, respectively). CYP2B6 PMs (n = 10) were significantly related to a higher reduction in pain 30 min after tramadol intake (univariate p = 0.038, multivariate p = 0.016, unstandardized β coefficient = 0.224, R2 = 0.178), to lower PACU admission time (p = 0.007), and to lower incidence of adverse drug reactions (p = 0.038) compared to the other phenotypes. CYP3A4 IMs and PMs showed a higher prevalence of drowsiness and dizziness (p = 0.028 and 0.005, respectively). Our results suggest that the interaction of CYP2B6 and CYP2D6 phenotypes may be clinically relevant, pending validation of these results in large, independent cohorts. Additional research is required to clarify the impact of CYP3A4 genetic variation on tramadol response.

Novel drug treatments for pain in advanced cancer and serious illness: a focus on neuropathic pain and chemotherapy-induced peripheral neuropathy.

Drugs that are commercially available but have novel mechanisms of action should be explored as analgesics. This review will discuss haloperidol, miragabalin, palmitoylethanolamide (PEA), and clonidine as adjuvant analgesics or analgesics. Haloperidol is a sigma-1 receptor antagonist. Under stress and neuropathic injury, sigma-1 receptors act as a chaperone protein, which downmodulates opioid receptor activities and opens several ion channels. Clinically, there is only low-grade evidence that haloperidol improves pain when combined with morphine, methadone, or tramadol in patients who have cancer, pain from fibrosis, radiation necrosis, or neuropathic pain. Miragabalin is a gabapentinoid approved for the treatment of neuropathic pain in Japan since 2019. In randomized trials, patients with diabetic neuropathy have responded to miragabalin. Its long binding half-life on the calcium channel subunit may provide an advantage over other gabapentinoids. PEA belongs to a group of endogenous bioactive lipids called ALIAmides (autocoid local injury antagonist amides), which have a sense role in modulating numerous biological processes in particular non-neuronal neuroinflammatory responses to neuropathic injury and systemic inflammation. Multiple randomized trials and meta-analyses have demonstrated PEA's effectiveness in reducing pain severity arising from diverse pain phenotypes. Clonidine is an alpha2 adrenoceptor agonist and an imidazoline2 receptor agonist, which is U.S. Federal Drug Administration approved for attention deficit hyperactivity disorder in children, Tourette's syndrome, adjunctive therapy for cancer-related pain, and hypertension. Clonidine activation at alpha2 adrenoceptors causes downstream activation of inhibitory G-proteins (Gi/Go), which inhibits cyclic Adenosine monophosphate (AMP) production and hyperpolarizes neuron membranes, thus reducing allodynia. Intravenous clonidine has been used in terminally ill patients with poorly controlled symptoms, in particular pain and agitation.

Dose rationale for gabapentin and tramadol in pediatric patients with chronic pain.

Despite off-label use, the efficacy and safety of gabapentin and tramadol in pediatric patients (3 months to <18 years old) diagnosed with chronic pain has not been characterized. However, generating evidence based on randomized clinical trials in this population has been extremely challenging. The current investigation illustrates the use of clinical trial simulations (CTSs) as a tool for optimizing doses and protocol design for a prospective investigation in pediatric patients with chronic pain. Pharmacokinetic (PK) modeling and CTSs were used to describe the PKs of gabapentin and tramadol in the target population. In the absence of biomarkers of analgesia, systemic exposure (AUC, Css) was used to guide dose selection under the assumption of a comparable exposure-response (PKPD) relationship for either compound between adults and children. Two weight bands were identified for gabapentin, with doses titrated from 5 to 63 mg/kg. This yields gabapentin exposures (AUC0-8 ) of approximately 35 mg/L*h (1200 mg/day adult dose equivalent). For tramadol, median steady state concentrations between 200 and 300 ng/mL were achieved after doses of 2-5 mg/kg, but concentrations showed high interindividual variability. Simulation scenarios showed that titration steps are required to explore therapeutically relevant dose ranges taking into account the safety profile of both drugs. Gabapentin can be used t.i.d. at doses between 7-63 and 5-45 mg/kg for patients receiving gabapentin weighing <15 and ≥15 kg, respectively, whereas a t.i.d. regimen with doses between 1 and 5 mg/kg can be used for tramadol in patients who are not fast metabolisers.

Adjustment of Analgesic in a Patient with Pain and Renal Dysfunction

Opioid drugs are widely used in the treatment of cancer pain. Renal dysfunction slows down the clearance of opioids, which can easily lead to drug accumulation and overdose, posing a challenge to safe medication. This article takes a patient with cancerous abdominal pain and chronic low back pain combined with severe renal function damage as an example. This patient experienced central inhibitory, such as somnolence, hypoxemia, and needle like pupil contraction during the use of oxycodone sustained-release tablets for pain treatment. Clinical pharmacist conducted a comprehensive pain assessment of patient and adjusted oxycodone sustained-release tablets to tramadol capsules. The physician followed the pharmacist's advice and the patient's pain was satisfactorily controlled without obvious adverse effects. This article discusses the pharmacological and pharmacokinetic characteristics of commonly used opioid drugs in clinical practice, as well as their application in patients with renal function impairment. This article also provides an in-depth analysis of the application of oxycodone and tramadol in patients with cancer pain, chronic low back pain, and renal function damage, based on case studies. This case suggests that for patients with severe renal dysfunction and opioid intolerance, it is not only necessary to choose drugs that are less reliance on renal clearance and short acting formulations, but also to gradually titrate from a small dose to an appropriate dose; For pain patients with complex clinical conditions, physicians should focus on collaborating with pharmacists to develop personalized and refined medication plans for patients, in order to achieve satisfactory pain control and ensure patient medication safety.

Recommandations pour le traitement de l’éjaculation prématurée

The Post-University Interdisciplinary Association of Sexology (AIUS) has brought together a panel of experts to develop French recommendations for the management of premature ejaculation. Systematic review of the literature between 01/1995 and 02/2022. Use of the clinical practice guidelines (CPR) method. We recommend giving all patients with PE psychosexological counseling, and whenever possible combining pharmacotherapies and sexually-focused cognitive-behavioral therapies, involving the partner in the treatment process. Other sexological approaches could be useful. We recommend the use of dapoxetine as first-line, on-demand oral therapy for primary and acquired PE. We recommend the use of lidocaine 150mg/mL/prilocaine 50mg/mL spray as local treatment for primary PE. We suggest the combination of dapoxetine and lidocaine/prilocaine in patients insufficiently improved by monotherapy. In patients who have not responded to treatments with marketing authorisation, we suggest using an off-label SSRI, preferably paroxetine, in the absence of a contraindication. We recommend treating ED before PE in patients with both symptoms. We do not recommend using α-1 blockers or tramadol in patients with PE. We do not recommend routine posthectomy or penile frenulum surgery for PE. These recommendations should contribute to improving the management of PE.

Anti-shivering effect of intrathecal tramadol versus intravenous tramadol in patients Received spinal anesthesia for lower limb surgery. A randomized controlled clinical trial

ABSTRACT Background Shivering occurs in 40–60% of patients under spinal anesthesia. Prophylaxis with intravenous tramadol produces a dose-dependent reduction in the incidence of shivering. Intrathecal Tramadol is used safely as an adjuvant in a dose up to 20 mg. Few studies tested the anti-shivering efficacy of intrathecal tramadol. However, no study compared the anti-shivering effect of the two different routes of tramadol. The aim is to compare the anti-shivering effect of intrathecal versus intravenous tramadol. This study was a randomized, triple-blinded parallel-design clinical trial, conducted in orthopedic operating room in our university hospital Material and Methods The study included 86 patients of ASA I & II aged 18 years or more who underwent lower limb orthopedic surgery that lasted less than 2 hours under spinal anesthesia. Patients were randomly allocated into two equal groups: control intravenous (IV) group and interventional intrathecal (IT) group. We used Amadol ampoules 100 mg/2 ml (Adwia company). Intervention The control group received IT 15 mg bupivacaine and then IV tramadol 0.25 mg/kg in 5 ml normal saline. The interventional group received 20 mg IT tramadol added to 15 mg bupivacaine then IV 5 ml normal saline. The patients were observed for intraoperative shivering, the primary outcome. Intraoperative hemodynamics, postoperative shivering, and its score were all recorded. Postoperative complications such as nausea, vomiting, and hypotension were documented. Results Intraoperative shivering was observed in 18.6% of the patients in IV group compared to 4.6% of patients in the IT group with a P-value of 0.047. Conclusions IT tramadol is more efficient in preventing post-spinal shivering compared to IV tramadol.

Comparative study of analgesic effect of epidural ketamine vs. epidural tramadol in patients undergoing mastectomy under thoracic epidural anesthesia

ABSTRACT Breast surgery under epidural procedure is a secure, accepted alternative to general anesthesia and can increase the outcome postoperatively with less cost. Postoperative analgesia provides a better outcome, early regain of activity with the least side effects, and early discharge. This study compares the analgesic efficacy of thoracic epidural ketamine versus thoracic epidural tramadol when added to bupivacaine at 0.5% for patients who underwent mastectomy under epidural anesthesia. Methods Our study included 50 female participants belonging to the 18–60-year-old age group who were epidurally anesthetized for mastectomy operation. Participants were randomly assigned to the ketamine group (epidural bupivacaine and ketamine 50 mg) (KG) and the tramadol group (epidural bupivacaine and tramadol 1 mg/kg) (TG). Pain was measured using the visual analog scale (VAS), and the consumption of rescue analgesia was recorded as well. Nausea and vomiting, sedatives, and vasopressors were recorded and compared between both groups. Results KG showed a decrease in VAS scores, less consumption of rescue analgesia, lesser need for antiemetic, and has demanded for more sedation in comparison with TG when observed in the post-anesthesia care unit (PACU) for 24 h postoperatively. Our study could not detect significant differences between groups among recorded demographic data, hemodynamic parameters, or the need for vasopressors. Conclusion Epidural ketamine provided a better analgesia and less need to rescue analgesia, less incidence of nausea and vomiting, but more sedation when compared with epidural tramadol at a dose of 1 mg/kg

Use of tramadol and the risk of bleeding complications in patients on oral anticoagulants: a systematic review and meta-analysis.

This systematic review and meta-analysis aimed to determine whether tramadol intake increases the risk of bleeding in patients receiving oral anticoagulants. This systematic review was registered on PROSPERO, CRD42022327230. We searched PubMed and Embase up to 14 April 2022, and references and citations of included studies were screened. Comparative and non-comparative studies exploring bleeding complications among adult patients on oral anticoagulants and tramadol were included. Risk of bias was assessed using an adaptation of the Drug Interaction Probability Scale for case reports and case series and the Newcastle-Ottawa Scale for comparative studies. A meta-analysis was performed for the risk of serious bleeding (leading to hospitalisation or death) associated with tramadol in patients on vitamin K antagonists. A total of 17 studies were included: 1 case series, 12 case reports, 2 case-control studies and 2 cohort studies. Most of the studies described tramadol-vitamin K antagonists' concomitant use; one case-control study also assessed dabigatran and rivaroxaban; one case report involved dabigatran. Among case reports/series, a total of 33 patients had a bleeding complication while using tramadol and an oral anticoagulant. The 4 comparative studies reported an increased bleeding risk during tramadol and vitamin K antagonist intake which was statistically significant in one study; the pooled risk ratio of serious bleeding was 2.68 [95% CI: 1.45 to 4.96; p < 0.001]. This systematic review confirms an association between tramadol use and risk of bleeding in patients on vitamin K antagonists. Evidence is too limited to assess whether this risk extends to patients on direct oral anticoagulants, and further studies are needed.

Local Tramadol Improves the Anesthetic Success in Patients with Symptomatic Irreversible Pulpitis: A Meta-Analysis.

Symptomatic irreversible pulpitis is a painful clinical condition with a broad inflammatory component. Dental anesthesia in these patients is affected by the inflammatory process, reporting a high incidence of anesthesia failure. The aim of this systematic review and meta-analytical evaluation was to determine the effect of pre-treatment with tramadol in patients with symptomatic irreversible pulpitis, as well as for pain control and adverse effects. This study was registered in PROSPERO (ID: CRD42021279262). PubMed was consulted to identify clinical investigations comparing tramadol and placebo/local anesthetics in patients with symptomatic irreversible pulpitis. Data about the anesthesia, pain control, and adverse effects were extracted. Both the anesthetic success index and the adverse effects of local tramadol and placebo were compared with the Mantel–Haenszel test and odds ratio. Data analysis showed that the local administration of tramadol increased the anesthetic success rate when compared to placebo in patients with symptomatic irreversible pulpitis (n = 228; I2 = 0; OR = 2.2; 95% CIs: 1.30 to 3.79; p < 0.004). However, local administration of tramadol increased the risk of adverse effects when compared to placebo/local anesthetics (n = 288; I2 = 0; OR = 7.72; 95% CIs: 1.37 to 43.46; p < 0.02). In conclusion, this study shows that the local administration of tramadol increases the anesthetic success index when compared to placebo in patients with symptomatic irreversible pulpitis.

A comparative study of postoperative analgesia and safety of intravenous nalbuphine versus intravenous tramadol in patients undergoing lower abdominal surgeries

A comparative study of postoperative analgesia and safety of intravenous nalbuphine versus intravenous tramadol in patients undergoing lower abdominal surgeries

The Effect of Ondansetron on the Analgesic Efficacy of Tramadol in Patients Undergoing Laparoscopic Cholecystectomy.

Purpose Investigating the effect of ondansetron on the efficacy of tramadol in patients undergoing laparoscopic cholecystectomy. Methods Sixty American Society of Anesthesiologists (ASA) I-II patients over the age of 18 who underwent laparoscopic cholecystectomy were included in this study. All patients were given 1 mg/kg tramadol intravenously (iv) during the intraoperative period. Patients were randomly assigned to receive either 4 mg ondansetron (Group O) or 2 mL saline (Group S). Postoperative tramadol consumption, pain score (NRS), intensity of nausea (NRS), presence of vomiting, consumption of rescue analgesics and antiemetics, and patient satisfaction were recorded. Results A total of 60 patients were enrolled in the study; five patients were excluded due to deviation from the protocol. Data from 55 patients (Group O: 28 patients, Group S: 27 patients) were evaluated in the study. No differences between the two groups were detected for postoperative consumption of tramadol, pain score (NRS), intensity of nausea (NRS), presence of vomiting, consumption of rescue analgesics and antiemetics, and patient satisfaction. Conclusions The results showed that coadministration of tramadol and ondansetron did not change tramadol consumption during the postoperative 24 hours after laparoscopic cholecystectomy. Clinical trial registration number is as follows: https://clinicaltrials.gov/ct2/show/NCT04745273—01/31/2021.

Comparison of Intravenous Nefopam and Tramadol for Postoperative Analgesia in Adult Patients Scheduled for Laparoscopic Abdominal Surgeries under General Anesthesia: A Prospective, Randomized, Double-Blind Study

Background and Aims: Nefopam and tramadol have been used for postoperative analgesia in the various clinical settings. This study aims to evaluate and compare the postoperative analgesic effects of intravenous nefopam and tramadol in adult patients undergoing laparoscopic abdominal surgeries.Materials and Methods: One hundred and twenty-six adult patients of the American Society of Anesthesiologists physical Status I and II, age group of 20–60 years undergoing elective or emergency laparoscopic abdominal surgeries under general anesthesia were allocated randomly into two groups. In the postanesthesia care unit, patients in Group A (n = 63) and Group B (n = 63) received Nefopam 20 mg and Tramadol 100 mg, respectively, as intravenous infusion in 100 ml 0.9% saline over 15 min. The same doses were repeated every 6th hour or if the Visual Analog Scale (VAS) score was ≥4. Postoperative VAS scores were recorded at 30 min, 1.5 h, 3 h, 6 h, 12 h, 18 h, and 24 h. The hemodynamic parameters were recorded just before and after the completion of the infusion of study drugs. P < 0.05 was considered statistically significant.Results: The pain score was significantly lower in Group A (Nefopam) than in Group B (Tramadol). The difference in mean VAS scores between the two groups was statistically significant at 1.5 h, 3 h, 6 h, 12 h, 18 h, and 24 h after postoperatively (P < 0.05). There was no statistically significant difference in the incidence of side effects in both groups.Conclusion: Intravenous nefopam provided better postoperative pain relief than Tramadol in patients undergoing laparoscopic surgeries under general anaesthesia.

Pre-emptive analgesia efficacy of piroxicam versus tramadol in oral surgery.

This double-blind randomized controlled trial (RCT) was conducted to evaluate the pre-emptive analgesia and anti-inflammatory efficacy of piroxicam compared with tramadol in patients undergoing oral surgery. Seventy-eight patients who required extraction of impacted mandibular third molars were randomized into three treatment groups of 26 patients each: group I received 100 mg of tramadol, group II received 20 mg of piroxicam, and group III received a placebo. Drugs were administered intramuscularly 30 min prior to the extraction procedure. Pain intensity, time to first analgesic administration, total analgesic consumption, facial edema, and trismus were the outcomes of interest. The group receiving 20 mg of piroxicam showed significantly lower pain intensity, increased time to first analgesic, and reduced edema from preoperative to postoperative day seven than those in the tramadol and placebo groups. The findings of this study showed that piroxicam had significant pain relief efficacy after third molar surgery compared with that in tramadol.

Comparison of postoperative analgesic efficacy of epidural ropivacaine and ropivacaine with tramadol in adults undergoing abdominal surgeries under general anaesthesia

Objectives: This prospective study was conducted to compare the postoperative analgesic efficacy of epidural 0.2% Ropivacaine and 0.2% Ropivacaine with Tramadol in patients undergoing abdominal surgeries under general anesthesia.Observations:•The duration of analgesia in postoperative period in patients who received epidural 0.2% Ropivacaine with Tramadol was comparatively longer than that of patients who received epidural 0.2% Ropivacaine.•The Ramsay sedation score was observed to be more in patients who received epidural 0.2% Ropivacaine with Tramadol compared to patients who received epidural 0.2% Ropivacaine.•There was no significant difference in the postoperative nausea and vomiting episodes in both the groups.•There was no significant difference in occurrence of pruritus in both the groups.•There was no statistical difference between the two groups with respect to heart rate, mean arterial pressure, oxygen saturation and respiratory rate.

Safety and efficacy of "on-demand" tramadol in patients with premature ejaculation: an updated meta-analysis.

ABSTRACTIntroduction:Tramadol has been used for the treatment of premature ejaculation, however, the studies published for the same are not well designed. The primary objective of this study was to explore the literature pertaining to the use of tramadol in patients with PE to determine its safety and efficacy in this population.Materials ande methods:Systematic literature search of various electronic databases was conducted to include all the randomized studies and quasi-randomized studies. Standard PRISMA (Preferred reporting Items for Systematic reviews and Meta-analysis) guidelines were pursued for this review and study protocol was registered with PROSPERO (CRD42019123381).Results:Out of 9 studies included in this review, 5 were randomized controlled trials, and rests of the 4 studies were quasi-randomized studies. Tramadol resulted in significantly higher improvement of IELT with the mean difference (MD) of 139.6 seconds and confidence interval (CI) 106.5-172.6 seconds with a p-value of p <0.00001. All dosages except 25mg fared well as compared to placebo. Tramadol fared better than placebo at 1 month, 2 months, and 3 months after initiation of therapy as compared to the placebo. Tramadol group had reported a significantly higher number of adverse events with treatment as compared to placebo but none of them were serious.Conclusion:Tramadol appears to be an effective drug for the management of PE with a low propensity for serious adverse events. However, evidence obtained from this study is of low to moderate quality. Furthermore, effective dose and duration of therapy remain elusive.

The randomized clinical trial of safety and efficacy of oral tramadol in patients undergoing colonoscopy

The randomized clinical trial of safety and efficacy of oral tramadol in patients undergoing colonoscopy

A Randomized Double Blinded Comparative Study on Efficacy of Intraoperative Dexmedetomedine versus Tramadol Intravenous Infusion in Prevention of Postoperative Shivering Following Spinal Anaesthesia

Introduction: Shivering is a frequent complication reported in 30 to 40% of patients undergoing surgery under regional anaesthesia. It increases oxygen consumption, hypercarbia and minute ventilation. It induces arterial hypoxemia, lactic acidosis, increased intra-ocular pressure, and interferes with patient monitoring and comfort. Most of the studies done in the past have been in the treatment of shivering rather than prevention. This study compared intravenous dexmedetomidine versus intravenous tramadol for prevention of shivering in patients who received spinal anaesthesia for various surgical procedures. Aims and objectives: The aim of this study was to study and compare the efficacy of intravenous infusion of low dose dexmedetomidine (0.25mcg/kg) vs Tramadol (0.5mg/kg) in the prevention of postoperative shivering. Primary objective was prevention of shivering and Secondary objectives were sedation, hemodynamic changes and nausea and vomiting. Materials and Methods: Prospective randomised double blinded comparative study was done on patients scheduled for elective surgery during June 2018-March 2019 in GKNM Hospital, Coimbatore. Patients were included as per criteria. Informed and written consent was obtained and randomized by computer. Group D received IV Dexmedetomidine of 0.25mcg/Kg dose and Group T received IV Tramadol of 0.5mg/kg. Data was collected and analyzed. Patients were evaluated post operatively by the investigator who was blinded to the group assigned. Results: The mean age of the total population was 39.55 ± 11.73 years with male predominance in tramadol group. Dexmedetomedine was more effective in preventing shivering, 16 patients (40%) of group D had shivering compared to 24 patients (60%) of tramadol group. This difference though was not statistically significant, numerically showed that dexmedetomedine was better in prevention of shivering. The tramadol group had early onset of shivering in comparison to Dexmedetomedine group (p&lt;0.05). Dexmedetomedine group had higher grades of sedation and incidence of nausea and vomiting was higher in tramadol group. Conclusion: Dexmedetomedine even at a lower dose is comparatively a more effective drug for prevention of shivering with fewer side effects than tramadol in patients undergoing surgery under spinal anaesthesia.

A Prospective Comparative Study to Assess-Post Operative Analgesic Effect of Intraperitoneal Instillation of Bupivacaine with Dexmedetomidine to Bupivacaine with Tramadol in Patients Undergoing Laparoscopic Cholecystectomy

A Prospective Comparative Study to Assess-Post Operative Analgesic Effect of Intraperitoneal Instillation of Bupivacaine with Dexmedetomidine to Bupivacaine with Tramadol in Patients Undergoing Laparoscopic Cholecystectomy