Abstract
Background: Post-spinal shivering (PSS) is a common spinal anesthesia complication and occurs in approximately 40-70 percent of patients and is characterized by excessive physiological stress particularly in orthopedic surgeries.
Purpose: The aim was to compare the efficacy of prophylactic intravenous ketamine and intravenous tramadol in the prevention of post-spinal shivering to evaluate the study in orthopedic surgical patients. Methodology: The study was a cross-sectional one that utilized 74 patients who were undergoing orthopedic surgery under spinal anesthesia. A randomization to two groups was done in which Group K used intravenous ketamine (0.5 mg/kg) and Group T was intravenous tramadol (1 mg/kg). The method of assessment of shivering involved a standardized five-point shivering scale at 10 -minute intervals over an hour. Hemodynamic parameters and adverse effects were also taken note. Chi-square and independent t-tests were conducted as the statistical tests, and a p-value of less than 0.05 was taken as statistically significant. Findings: Tramadol was clearly a better inhibitor of post-spinal shivering than ketamine, both in terms of incidence and severity. The majority of patients under the tramadol group showed Grade 0-1 shivering, and the patients under the ketamine group more often had moderate and severe shivering. Ketamine was linked to a greater drowsiness and at times, hallucinations, whilst tramadol was linked to only slight nausea and vomiting. The finding of a correlation between the older age and more shivering was made.
Conclusion: Tramadol proved to be superior in terms of efficacy, safety and hemodynamic stability over ketamine. Since it is cheap and accessible, tramadol can be a first-line prophylactic agent in the prevention of post-spinal shivering, especially in the resource-limited environment