Comparison of intravenous butorphanol, ondansetron and tramadol for control of shivering during regional anesthesia: a prospective, randomized double-blind study

We conducted this study to compare the efficacy and safety of butorphanol, ondansetron and tramadol for control of shivering in patients undergoing surgical procedures under spinal anesthesia. In this prospective double-blind, randomized, controlled study, 150 patients of both genders, 18-60 years old, ASA I or II, booked for elective surgery under spinal anesthesia were randomly distributed into three groups of 50 each. Each patient, who developed shivering, was given either 0.03 mg/kg of inj. butorphanol 1% [Group-B], 0.06 mg/kg of inj. ondansetron [Group-O] or 1.0 mg/kg of inj. tramadol 1% [Group-T] IV. Demographic characteristics, incidence of shivering, response rate after 1, 3, 5, 10 and 20 min, recurrence rate, hemodynamic parameters and complications were observed. All patients were relieved of shivering after butorphanol; 66.6% of them were relieved within 1 min, 93.33% within 3 min and 100% within 5 min. Ondansetron could relieve shivering in only 29.4% of the patients; 5.88% within 1, 11.76% within 3, 23.52% within 10 and 29.4% within 20 min. Tramadol relieved shivering in 92.30%; 46.15% within 1, 84.61% within 3 and 92.30% within 5 min respectively [p < 0.05]. Recurrence of shivering was observed in 26.67% of butorphanol group and 15.38% of tramadol group [p> 0.05]. Ondansetron was not found to be much effective for the control of shivering during regional anesthesia. Butorphanol and tramadol were equally effective in controlling shivering under regional anesthesia, the only difference being in their onset of action. Butorphanol was quicker in onset which is essential for control of shivering and should be preferred

Comparison of different doses of clonidine as an adjuvant to intrathecal bupivacaine for spinal anesthesia and postoperative analgesia in patients undergoing caesarian section

The necessity to find out the lowest possible effective dose of clonidine to avoid its known side effects like hypotension, bradycardia and sedation prompted us to design present study. We compared different doses of clonidine as an adjuvant to intrathecal bupivacaine for spinal anesthesia in patients undergoing caesarian section aiming to find out the lowest possible effective dose. In a prospective, double-blind, randomized controlled study, 60 parturients 18 to 35 years of age, ASA grade I or II, posted for caesarian section were randomly distributed into three equal groups, BC60, BC30 and BC15. Patients were given 2.0 ml of hyperbaric bupivacaine 0.5% with 60 micro g, 30 micro g or 15 micro g of clonidine intrathecally respectively. Hemodynamic parameters, onset, peak and duration of sensory and motor block, level of sedation and duration of postoperative analgesia were compared. All groups were comparable with respect to demographic profile, onset, peak and duration of sensory and motor block and overall hemodynamic stability. We observed dose dependent variability in duration of analgesia and sedation. Duration of analgesia was significantly higher in BC60 group as compared to the other two groups [598.7 +/- 140.47 vs. 436.65 +/- 149.84 and 387.1 +/- 97.05 minutes respectively]. Sedation was also more in BC 60 group. Addition of 60 micro g clonidine to intrathecal bupivacaine provides longer duration of postoperative analgesia than 15 micro g or 30micro g but with more sedation. We get fairly good analgesia with less sedation in 15micro g and 30micro g clonidine and are better options when sedation is not desirable