COMPARISON OF KETAMINE VERSUS TRAMADOL IN PREVENTION OF PERIOPERATIVE SHIVERING IN PATIENTS UNDERGOING CESAREAN SECTION UNDER SPINAL ANAESTHESIA

Abstract

Background: Spinal anaesthesia during cesarean sections often causes perioperative shivering, which can cause severe physiological abnormalities and patient discomfort. The purpose of this study was to examine the efficacy of intravenous ketamine and tramadol in reducing perioperative shivering in women undergoing caesarean section under spinal anaesthesia. Method: A randomized controlled experiment was done at Liaquat University of Medical and Health Sciences, with 70 women undergoing elective cesarean sections. Participants were randomly allocated to receive either ketamine (0.25 mg/kg) or tramadol (0.5 mg/kg) intravenously prior to surgery. Demographic and clinical data were gathered. Shivering intensity was measured every 10 minutes for up to 60 minutes using a recognized grading scale. The primary outcome was the frequency of shivering, and the statistical analysis used chi-square tests and logistic regression to account for possible variables of influence. Results: The ketamine group had a considerably greater rate of successful shivering avoidance (Grade 0-1) compared to the tramadol group (22.9%) (p < 0.001). Ketamine was found to be more effective (adjusted OR = 7.5, 95% CI: 2.7-20.5, p < 0.001) than other treatments, regardless of age, BMI, diabetes, or hypertension. Both groups had similar baseline characteristics. Conclusion: Intravenous low-dose ketamine outperforms tramadol in reducing perioperative shivering in cesarean patients under spinal anaesthesia. Its constant efficacy, safety profile, and thermoregulatory effects make it an ideal drug for shivering prophylaxis in obstetric anaesthesia.