Background and Aims: The present study designed to compare the clinical efficacy, hemodynamic and side effects of nalbuphine and tramadol, when used for control of post‑spinal anesthesia shivering.

Methods: A prospective, randomised, and double‑blind study was conducted in 90 American Society of Anesthesiologists Grade I and II patients of either gender, aged between 18-60 years, who subsequently developed shivering grade 3 or 4, scheduled for various surgical procedures under spinal anesthesia. The patients were randomized into two groups of 45 patients each to receive either nalbuphine 0.06 mg/kg (Group N) or tramadol 1 mg/kg (Group T). Grade of shivering, onset of shivering, time interval for cessation of shivering, response rate at 5 min and 30 min, rescue dose, hemodynamic parameters and adverse effects were observed at scheduled intervals. Independent t‑test was used for analysing the data.

Results: Time taken for cessation of shivering was significantly less with nalbuphine when compared to tramadol (p<0.05). It was observed that the response time at 5 min and 30 min and rescue dose requirement for control of shivering was not much difference (p>0.05). However, sedation was significantly more in the nalbuphine group and tramadol significantly causes more nausea and vomiting.

Conclusion: Both nalbuphine (0.06 mg/kg) and tramadol (1 mg/kg) are effective in treating patients with post‑spinal anesthesia shivering. However, the time taken for cessation of shivering is significantly less with nalbuphine when compared to tramadol. Furthermore, tramadol causes significantly more nausea and vomiting, however, nalbuphine causes significantly more sedation.

Key words: Nalbuphine, post‑spinal anesthesia shivering, tramadol