Background:
Shivering is described as an involuntary, spontaneous, and repetitive muscular movement. Hypothermia is one of the frequent causes that lower the shivering threshold.
Patients and Methods:
A prospective, randomized, double-blind, placebo-controlled study that approved by Mustasharak Hospital, KSA.150 patients scheduled for surgery under SA from March 2017 to December 2018 were included. After SA, patients were randomized to: (K) group = ketamine (0.2 mg/kg intravenously), (T) group = tramadol (0.5 mg/kg) and (S) group = saline (5 mL saline). The tympanic and core temperatures were documented every 5 minutes until the end of the surgery. Shivering scores were reported every 5 minutes and every 10 minutes postoperatively for 60 minutes. Hemodynamics were reported every 5 minutes intraoperatively and every 10 minutes postoperatively for 60 minutes. Adverse events were reported. The level of sedation was valued according to a five-point scale.
Results:
There was no significant difference between groups (p0.261). The incidence of grade 3 shivering showed a statistically significant difference (p0.03) in the saline group as compared to other groups. Time to the onset of shivering was statistically different among the groups (p0.001). There was a significant decrease in tympanic temperature after SA with respect to baseline values. Tympanic and core temperature changes over time in each group were statistically significant (p0.002).
Conclusion:
The prophylactic administration of low-dose IV ketamine or tramadol is effective in reducing the incidence and intensity of shivering in patients having surgery under SA with the priority to tramadol.