Randomized Double-Blinded Comparative Study of Intravenous Nalbuphine and Tramadol for the Treatment of Postspinal Anesthesia Shivering

Shivering is one of the most commonly recognized complications of the central neuraxial blockade. For optimal perioperative care, control of postspinal anesthesia shivering is essential. The present study designed to compare the clinical efficacy, hemodynamic parameters, and side effects of nalbuphine and tramadol for control of postspinal anesthesia shivering. This was a prospective, randomized, double-blind study. This study was conducted on 90 American Society of Anesthesiologists Physical Status I and II patients of either gender, aged between 18 and 60 years, who subsequently developed shivering grade 3 or 4, scheduled for different surgical procedures under spinal anesthesia. The patients were randomized into two groups of 45 patients each to receive either nalbuphine 0.06 mg.kg (Group N) or tramadol 1 mg.kg (Group T). Grade of shivering, onset of shivering, time interval for cessation of shivering, response rate at 5 and 30 min, rescue dose, hemodynamic parameters, and side effects were observed at scheduled intervals. Independent -test and Chi-square/Fisher's exact test were used to analyze the data. The time taken for cessation of shivering was significantly less with nalbuphine in comparison with tramadol ( < 0.05). It was observed that the response time at 5 and 30 min and rescue dose requirement for control of shivering were not much difference ( > 0.05). Both nalbuphine and tramadol are effective; however, the time taken for cessation of shivering is significantly less with nalbuphine when compared to tramadol. Furthermore, tramadol causes significantly more nausea and vomiting; however, nalbuphine causes significantly more sedation.