The effects of intravenous tramadol and dexmedetomidine on shivering during arthroscopic surgery under spinal anesthesia

Shivering is an undesired complication seen at postoperatively. Shivering under regional anesthesia (RA) was found 39% at previous studies. There are many pharmacological treatments to control the shivering. But some of these treatments can be inconvenient under regional anesthesia. In our study, we aimed to compare the adverse effects and the ability of preventing the shivering of prophylactic tramadol and dexmedetomine. 90 ASA physical status I-II, aged 18-60 years patients undergoing elective arthroscopic surgery with spinal anesthesia were divided into 3 groups randomly. After spinal blockade in group T (n=30) 100 mg tramadol in 100 ml saline and in group D (n=30) 0.5 µg/kg dexmedetomidine in 100 ml saline and in group P (n=30) 100 ml saline administered in 10 minutes. Intra operatively and 45 minutes after postoperative period, we measured the non-invasive arterial blood pressure, heart rate, oxygen saturation, tympanic temperature, shivering and sedation scores and observed for the adverse effects such as nause and vomitting, bradycardia, hypotension, and treated as needs. In group T and D at 20 th minute shivering score were significantly lower compared to group P (p<0.05). Sedation scores were significantly higher in group D after 5th minute (p<0.05). There was no significant difference between groups in terms of adverse effects such as hypotension, bradicardya, nause and vomitting (p<0.05) and no desaturation observed. We concluded that prophylactic tramadol and dexmedetomidine are effective to prevent the shivering under spinal anesthesia. In addition, dexmedetomidine was superior to make low level of sedation which is enough to prevent the anxiety without any adverse effects.Key words: Thermoregulation, Shivering, Spinal anesthesia, Dexmedetomidine, Tramadol.