A Randomized Controlled Trial Comparing Intravenous Tramadol and Dexmedetomidine for the Prevention of Perioperative Shivering During Transurethral Resection of Prostate Under Spinal Anesthesia
Vinayaka Jannu, Nikitha Jetti, Guruprasad ShettyAbstract
Background:
Perioperative shivering is a common complication during spinal anesthesia, particularly in patients undergoing transurethral resection of the prostate (TURP), due to impaired thermoregulation and heat loss from irrigation fluids. “It can increase metabolic demand and cause patient discomfort, making its prevention clinically important.
Aim and Objectives:
The aim and objectives of this study were to compare the efficacy of intravenous tramadol and dexmedetomidine in preventing perioperative shivering in TURP under spinal anesthesia, and to assess associated temperature changes, sedation, need for additional interventions, and adverse events.
Materials and Methods:
This prospective, randomized, double-blind study included 100 male patients (ASA I–II, 50–80 years) undergoing TURP under spinal anesthesia. Patients were divided into two groups of 50 each. Group T received intravenous tramadol 1 mg/kg, whereas Group D received intravenous dexmedetomidine 1 µg/kg, administered before spinal anesthesia. Core and surface temperatures, shivering incidence, sedation scores, and adverse events were recorded up to 90 min.
Results:
Baseline characteristics were comparable between groups. Group T showed significantly higher core and surface temperatures at several time points. Shivering incidence was significantly lower in Group T at 15 and 30 min.” Sedation was higher in Group D. Additional interventions were required less frequently in Group T (6% vs. 26%). Bradycardia and hypotension were significantly higher in Group D.
Conclusion:
Intravenous tramadol is more effective and safer than dexmedetomidine for preventing perioperative shivering in TURP under spinal anesthesia.