The Effect of Ketamine Versus Tramadol on Prophylactic Post-Spinal Shivering in Those Patients Undergoing Orthopedic Surgery

Abstract

Background/Objective: Orthopedic patients have a particularly high risk for post-spinal shivering, a typical consequence of spinal anesthesia. Without treatment, shaking may worsen wound pain, increase oxygen use, and impair healing. There have been a number of studies looking at the efficacy of ketamine and other medications for reducing post-spinal shivering. Despite this, there is a dearth of data on more effective and widely available preventive medicines. As a result, the purpose of this research was to evaluate the efficacy of 0.25 mg/kg of Ketamine (K) against 0.5 mg/kg of Tramadol (T) in preventing shivering after spinal anesthesia.

Methodology: 200 patients who were to have orthopedic surgery under spinal anesthesia were randomly chosen to participate in this prospective cohort study. Patients who were given a prophylactic dosage of intravenous ketamine prior to spinal anesthesia are referred to as the Ketamine group(n=100), whereas those who were given Tramadol are referred to as the Tramadol group (N=100). During the intraoperative phase, vital signs such as shivering intensity and frequency, blood pressure, heart rate, and axillary body temperature were monitored hourly at 10-minute intervals for a whole hour.

Results: There were 87 patients (43%) who had post-spinal shivering; this number was 32 (32%) for those given ketamine and 55(55%) for those given tramadol (p=0.001). With a p-value of 0.000, the incidence of nausea and vomiting was statistically significantly higher in the tramadol group of 82(82%). The ketamine group had significantly more intraoperative sedation than the tramadol group (p 0.007).

Conclusion: After spinal anesthesia, low-dose ketamine is more active in lowering the frequency and intensity of shivering. Therefore, we advise patients having orthopedic surgery under spinal anesthesia to take low-dose ketamine beforehand as a preventative measure against post-spinal shivering.

Keywords: Ketamine, Tramadol, Shivering, Orthopedic surgery