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    Journal of Pharmacology and PharmacotherapeuticsNOW IN
    Article

    Comparing the Effect of Intravenous Tramadol and Intravenous Nalbuphine in Addition to Midazolam for the Control of Shivering after Spinal Anesthesia

    Apoorva Madem1, Sravanthi Parusha1, Dinakar Mallem2, Indira Pacharla1★, Vijay Kotra3★, Wen Han Chooi4, Rebecca Shin Yee Wong5, Long Chiau Ming5, Ali Saleh Alkhoshaiban6, Khang Wen Goh7★ Corresponding author

    1. 1Department of Anesthesiology, MNJ Institute of Oncology & Research Centre for Cancer, Hyderabad, Telangana, INDIA.
    2. 2Department of Forensic Medicine, Apollo Institute of Medical Sciences and Research, Hyderabad, Telangana, INDIA.
    3. 3Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Quest International University, Ipoh, Perak, MALAYSIA.
    4. 4Department of Medicine, Faculty of Medicine, Quest International University, Ipoh, Perak, MALAYSIA.
    5. 5Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Sunway City, MALAYSIA.
    6. 6Pharmacy Practice Department, College of Pharmacy, Qassim University, Qassim University Medical City, SAUDI ARABIA.
    7. 7Department of Data Science, Faculty of Data Science and Information Technology, INTI International University, Nilai, MALAYSIA.

    CORRESPONDENCE

    Indira Pacharla

    Department of Anesthesiology, MNJ Institute of Oncology & Research Centre for Cancer, Hyderabad, Telangana, INDIA.

    indirapacharla6@gmail.com

    Received: 29-02-2024; Revised: 13-05-2024; Accepted: 16-05-2024.

    Volume 15, Issue 3 · pp. 264–276 · PUBLISHED 2024 · DOI: 10.1177/0976500X241262076

    View on J Pharmacol. Pharmacother. original site ↗

    ABSTRACT

    Introduction: Shivering is a common complication during neuraxial anesthesia, leading to metabolic and cardiovascular challenges. Existing treatments vary in effectiveness, and this study compares intravenous tramadol and nalbuphine, both administered with midazolam, for shivering control. Objectives: To evaluate and compare the efficacy of IV tramadol and IV nalbuphine, alongside midazolam, in controlling post-spinal anesthesia shivering. Materials and Methods: A prospective, randomized comparative clinical study involving 100 patients undergoing various surgical procedures under spinal anesthesia. Patients were divided into two groups to receive either IV Tramadol or IV Nalbuphine with midazolam. Parameters like shivering severity, time to cessation, recurrence, and side effects were recorded and analyzed. Results: Both tramadol and nalbuphine effectively controlled shivering with comparable response times and side effect profiles. There was no significant difference in the incidence of nausea, vomiting, and sedation between the groups. Hemodynamic stability was maintained throughout the study. Conclusion: IV tramadol and IV nalbuphine, in conjunction with midazolam, are effective in controlling post-spinal anesthesia shivering, with similar efficacy and safety profiles. They provide valuable options for clinicians in managing this common anesthetic complication. Further research is encouraged for more refined application in diverse patient populations.

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      Madem, A., Parusha, S., Mallem, D., Pacharla, I., Kotra, V., Chooi, W. H., Wong, R. S. Y., Ming, L. C., Alkhoshaiban, A. S., & Goh, K. W. (2024). Comparing the Effect of Intravenous Tramadol and Intravenous Nalbuphine in Addition to Midazolam for the Control of Shivering after Spinal Anesthesia. Journal of Pharmacology and Pharmacotherapeutics, 15(3), 264–276. https://doi.org/10.1177/0976500X241262076