Proposed topic of research:

“COMPARISON OF THE EFFICACY OF INTRAVENOUS DEXMEDETOMIDINE, PETHIDINE & TRAMADOL FOR PREVENTION OF PERIOPERATIVE SHIVERING IN PATIENTS UNDERGOING SPINAL ANAESTHESIA FOR UROLOGICAL SURGERIES”

Objectives of proposed research:

     GENERAL OBJECTIVE

a)      To compare the efficacy of intravenous Dexmedetomidine, Pethidine & Tramadol in prevention of peri operative shivering

    SPECIFIC OBJECTIVE

a)      To determine and compare the efficacy of intravenous Dexmedetomidine, Pethidine & Tramadol in prevention of perioperative shivering

b)     To compare the level of sedation caused by these study drugs

c)     To determine the adverse effects (if any) caused by these three drugs

Background of present study:

Spinal anaesthesia is widely used as a safe anaesthetic method for both elective and emergency urological surgeries providing a faster onset and effective motor and sensory blockade. Shivering is a known complication of spinal anaesthesia. It occurs in 40 to 70% of patients undergoing surgery under spinal anaesthesia .

Shivering causes increased metabolism and is associated with marked rise in oxygen consumption (up to 100 – 600%) of the tissue, thereby causing marked stress on the circulatory and respiratory systems. It also causes discomfort and increases surgical pain to the patients. It is associated with increase in intra-ocular pressure and intra cranial pressure . Shivering causes adverse peri operative outcomes like wound infection, increased surgical site bleeding and morbid cardiac events. It may also cause arterial hypoxemia, lactic acidosis and interfere with pulse rate, blood pressure (BP) and electrocardiographic (ECG) monitoring .

Various methods, available to control shivering during anaesthesia, include non-pharmacological and pharmacological methods. Non-pharmacological methods using equipment are effective but expensive and lack practicality while drugs like Pethidine, Tramadol, Clonidine, Dexmedetomidine, Ketamine, Nefopam are simple, cost-effective and easy to implement.

The aim of this study is to compare the efficacy, potency, haemodynamic effects, and side effects of intravenous Dexmedetomidine, Pethidine & Tramadol when given in pre-emptive dose to control shivering during spinal anaesthesia. We will further study the efficacy of the above drugs for the treatment of perioperative shivering

6.Methodology: 

An experimental study will be carried out among patients undergoing urological surgeries in IQ City Medical College & Hospital in Durgapur, West Bengal. Data will be collected over the 18 months period. Preoperative evaluation of the patients will be done on the day before surgery and all of them will be informed about the study. Written and informed consent will be obtained. On day of surgery, data will be obtained & statistical analysis will be done with help of appropriate statistical software.

7.Expected Outcome:

The present study not only will give us a picture of the efficacy of intravenous Dexmedetomidine, Pethidine, and Tramadol in preventing shivering after spinal anaesthesia in patients undergoing urological surgery, but will also reflect the intraoperative hemodynamic stability and adverse side effects of the three study drugs. Moreover, it will tell us about patients’ compliance.