Rifat Latif, Zainab Nazneen, Rabnawaz Khattak, Azmat Ali Shah, Afsheen Siddiqi, Bushra Aaqil, Qasim Mehmood.
Nalbuphine and Tramadol in the treatment of post spinal anesthesia shivering: a randomized control study.
Pak J Physiol Jan ;16(4):17-20.

Post-spinal anesthesia shivering is a frequent problem which can lead to certain hazardous complications as lactic acidosis and hypoxemia For the treatment of post-spinal shivering, tramadol and nalbuphine are commonly used and are readily obtainable. Objective: The aim of this study was to determine and compare the effectiveness of these two drugs in the treatment of post-spinal anesthesia shivering. Methodology: This study was conducted in Ayub Teaching Hospital, Abbottabad. It was a randomized controlled trial of 8 months from 26.07.2018-25.03.2019 It was conducted on 156 patients who developed post-shivering after cesarean section. These patients were divided into two groups after randomization with 78 patients in each group.  Group 1 patients were given tramadol while Group 2 patients were given nalbuphine both in a dose of 0.5 mg/kg. First base line shivering score of both groups of patients was noted down and then reassessed after 15 minutes of drug administration. Data was analyzed in SPSS 16 using Chi-square test. P-value ≤0.05 was considered as significant. Results: Tramadol was found to be effective in 58(74.4%) patients belonging to group 1 and not in 20(25.6%) while nalbuphine was found to be effective in 63(80.8%) patients belonging to group 2 and not in 15(19.2%).The difference between the two groups was found to be statistically insignificant. Conclusion: Both drugs tramadol and nalbuphine were found to be equally effective in the treatment of shivering after spinal anaesthesia.

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