A comparative study to ascertain the efficacy of intravenous dexmedetomidine versus intravenous tramadol to prevent post-operative shivering after laparoscopic surgery

Kishore K., Syed Ali Aasim, Manish Kumar J.


Background: Shivering is commonly encountered both after regional and general anaesthesia (GA) with a little higher incidence in patients receiving GA. The aim of study was to compare the effectiveness of dexmedetomidine and tramadol in decreasing postoperative shivering in patients undergoing laparoscopic surgery.

Methods: Total 120 patients were included in this study. In order to get a 5% level of significance and 80% power number of patients required in each group was 40, with a total of 120 patients. Randomization of groups was done based on closed envelope method. Patients were allocated into three groups group I, II and III of 40 patients each. Patients in group I and group II were administered 0.75 μg/kg of dexmedetomidine and 1.5 mg /kg of tramadol in 100 ml NS respectively half a before extubation, while patients in group III did not receive any pharmacological intervention.

Results: All three groups were comparable regarding distribution of age, gender, ASA grade and temperature at beginning and end of surgery and were non-significant.

Conclusions: Dexmedetomidine seems to possess anti-shivering properties and was found to reduce the occurrence of shivering in patients undergoing general anaesthesia with minimal side effects although its anti-shivering effect was not superior to tramadol.


ASA grade, Dexmedetomidine, Laparoscopic surgery, Tramadol

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Kranke P, Eberhart LH, Roewer N, Tramèr MR. Pharmacological treatment of postoperative shivering: a quantitative systematic review of randomized controlled trials. Anesthesia Analgesia. 2002;94(2):453-60.

Powell RM, Buggy DJ. Ondansetron given before induction of anesthesia reduces shivering after general anesthesia. Anesth Analg. 2000;90(6):1423-7.

Ciofolo MJ, Clergue F, Devilliers C, Ben MA, Viars P. Changes in ventilation, oxygen uptake, and carbon dioxide output during recovery from isoflurane anesthesia. Anesthesiol. 1989;70(5):737-41.

Bajwa SJ, Bajwa SK, Kaur J, Singh G, Arora V, Gupta S, et al. Dexmedetomidine and clonidine in epidural anaesthesia: A comparative evaluation. Indian J Anaesthesia. 2011;55(2):116.

Kamibayashi T, Maze M. Clinical uses of alpha-2 adrenergic agonists. Anaesthesiol. 2000; 93:1345-9.

Haselman MA. Dexmedetomidine: a useful adjunct to consider in some high-risk situations. AANA J. 2008;76(5):335-9.

Grond S, Sablotzki A. Clinical pharmacology of tramadol. Clinic Pharmacokinet. 2004;43(13):879-923.

Buggy D, Higgins P, Moran C, O’Donovan F, McCarroll M. Clonidine at induction reduces shivering after general anaesthesia. Canadian J Anaesthesia. 1997;44(3):263-7.

Kurz A, Ikeda T, Sessler DI, Larson M, Bjorksten AR, Dechert M, et al. Meperidine decreases the shivering threshold twice as much as the vasoconstriction threshold. Anesthesiol. 1997; 86:1046-54.

Liu ZX, Xu FY, Liang X, Zhou M, Wu L, Wu JR, et al. Efficacy of dexmedetomidine on postoperative shivering: a meta-analysis of clinical trials. Can J Anesthesia. 2015;62:816-29.