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Abstract

Background: Shivering following spinal anaesthesia is a common postoperative complication that can lead to patient discomfort, increased metabolic demand, and delayed recovery. Effective management of post-spinal shivering is essential for optimizing patient outcomes and enhancing perioperative care. Among pharmacologic agents used to control shivering, tramadol and nalbuphine are widely employed due to their central mechanisms of action. However, limited data exists comparing their efficacy, particularly within the local clinical setting.
Objective: To compare the efficacy of intravenous nalbuphine and tramadol in controlling shivering following spinal anaesthesia.
Methods: This randomized controlled trial was conducted in the Anesthesiology Department of Khyber Teaching Hospital, Peshawar, from 05-February to 05-August 2024. A total of 74 patients aged 18–75 years who developed shivering after spinal anaesthesia were enrolled and randomized into two equal groups. Group A (n = 37) received intravenous nalbuphine hydrochloride (0.06 mg/kg) and Group B (n = 37) received intravenous tramadol hydrochloride (1 mg/kg), both diluted in normal saline and administered over five minutes. The primary outcome was the time to control shivering, assessed by an experienced anesthesiologist. Data were analyzed using SPSS version 23, with a p-value ≤ 0.05 considered statistically significant.
Results: The mean age was 53.30 ± 14.55 years in Group A and 51.65 ± 14.70 years in Group B. Mean time to control shivering was 4.92 ± 1.01 minutes in the nalbuphine group and 4.11 ± 0.97 minutes in the tramadol group, showing a statistically significant difference (p = 0.001).
Conclusion: Tramadol was more effective than nalbuphine in rapidly controlling shivering following spinal anaesthesia, making it a preferable option for prompt perioperative thermoregulation.