Abstract

COMPARATIVE EVALUATION OF ORAL TRAMADOL AND GABAPENTIN FOR PROPHYLAXIS OF POST SPINAL SHIVERING

Ketki Jandial* and Mamta Gupta

ABSTRACT

Background: Tramadol is the most commonly employed agent for prevention and treatment of post-spinal shivering. Gabapentin, on the other hand, is observed to have anti-shivering effect, postulated to be due to anti-convulsive, anxiolytic and analgesic effect of gabapentinoids. This study was planned to compare premedication with oral gabapentin, tramadol and placebo, to compare the incidence and severity of shivering among the three groups. Method: A prospective controlled, randomized, double-blind study was conducted in the Department of Anesthesiology, Government Medical College, Jammu, over a period of 5 months on 96 adult patients, of either gender, scheduled for elective orthopaedic surgery under spinal anaesthesia and divided into three equal groups. Group T, administered tramadol 100 mg, Group G, administered gabapentin 600 mg and Control group, administered sugar filled capsules. Results: The incidence of shivering in Group T (22%) and in Group G (16%), was significantly lower than controls (46%) (P<0.05). Incidence of grade 3 shivering was significantly less in group T & group G (13% & 7%) as compared to controls (19%). The incidence of nausea/vomiting in group T (26%) and G (20%) was significantly less than in controls (48%). Incidence of dizziness/sedation (sedation score ≥2) was significantly more in group G (22%) as compared to group T (4%) and controls (0%). Conclusion: Both tramadol 100 mg and gabapentin 600 mg are equally effective for prevention of post spinal shivering in patients undergoing orthopaedic surgeries, however gabapentin can be associated with increased sedation score and lesser nausea and adverse effects.

Keywords: Tramadol, Gabapentin, Shivering.