Seifu, Ashenafi (2017) Efficacy of Meperidine Versus Tramadol as a Treatment Agent on Post Spinal Anaesthesia Shivering, Hemodynamic Stability and Therapeutic Side Effects in Parturients at Mateme Gandhi Memorial Hospital, Addis Ababa, Ethiopia, From 1-Dec-2016 To 28-Feb-2017: A Prospective Cohort Study. Masters thesis, Addis Ababa University.
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Abstract
Background: Spinal anesthesia is most commonly preferred anesthesia types in the clinical practice. Post Spinal Anesthesia Shivering (PSAS) is one of the frequent side effects of spinal anesthesia and results in ill patient outcome. It occurs during both general and spinal anesthesia, but it is more cumbersome during spinal anesthesia. From many approaches tried to overcome this problem; non-pharmacological one is supper effective in prevention of PSAS. But it is very costly and not applicable in all settings. The pharmacological approach is more commonly used and is accessible in almost all settings. Objective: The objective of the study was to compare the therapeutic effect of meperidine and Tramadol in control of PSAS during elective cescerean section in parturient who gave birth under spinal anesthesia, in the quest for a drug with more efficacy and less side effects. Methods and Materials: In this prospective cohort study 74 parturients of ASA I and II who underwent elective cescerean delivery under spinal anesthesia and developed PSAS at Gandhi Memorial Hospital from Dec 1, 2016-Feb 28, 2017 were included. Parturients were treated with either Meperidine 0.5 mg/kg (n=37) Tramadol 0.5mg/kg (n=37) depending on inclusion criteria. Time from treatment to cessation of PSAS in minutes, Hemodynamic variables before spinal anesthesia (baseline), after spinal anaesthesia, at 5,10 and 30 minutes after PSAS was treated were taken. Reoccurrence of PSAS and therapeutic side effects were recorded. Data were entered into Epi info version 7 and exported to SPSS version 20 for analysis. Differences of Categorical data were analyzed with the Chi-Square test. Numerical data between groups were evaluated using independent samples t-test or Mann-Whitney U test. A p value of <0.05 was considered to be statistically significant. Results: The hemodynamic changes like mean arterial pressure (MAP), Heart rate (HR), arterial saturation (Spo2) and body temperature changes were all comparable between the groups i.e. there was no statistically significant difference between the groups. Disappearance of shivering after treatment was significantly earlier in Tramadol group (3.08±1.3 minutes) than Meperidine group (4.45±3.18 minutes) (P<0.021). Recurrence of shivering after treatment was less in Tramadol group 6(16.2%) than Meperidine group 9(24.3%). Sedation as a side effect was higher in Meperidine group 9(24.3%) than Tramadol group 3(8.1%). Nausea and vomiting was, however, found to be higher in Tramadol group 9(24.3%) than Meperidine group 3(8.1%). These side effects, however, were not statistically significant. Dizziness and pruritus were not observed in clients of both groups. Conclusion: Both tramadol and pethidine effectively controlled shivering in clients during cesarean section under spinal anaesthesia. But tramadol offered rapid onset, less recurrence and less sedation as a side effect when compared to meperidine. Recommendation: we recommend responsible health professionals and authorities of health organizations to implement tramadol for the treatment of PSAS during cescerean section.
| Item Type: | Thesis (Masters) |
|---|---|
| Subjects: | R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RA Public aspects of medicine > RA1001 Forensic Medicine. Medical jurisprudence. Legal medicine |
| Divisions: | Africana |
| Depositing User: | Vincent Mpoza |
| Date Deposited: | 02 Jul 2018 10:12 |
| Last Modified: | 02 Jul 2018 10:12 |
| URI: | http://thesisbank.jhia.ac.ke/id/eprint/6406 |
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