Search

Objectives: This study was conducted to assess the prevalence of post anaesthesia shivering and the role of Tramadol in its control in elective spinal surgery patients. Introduction: Postoperative shivering is a common side effect of general anaesthesia. Up to 40% of patients develop postanaesthesia shivering (PAS). Several empirical therapeutic methods are applied for PAS but their overall quality is low. The pharmacological and non-pharmacological anti-shivering methods are in use for controlling PAS. Different medications are analyzed but the conclusion about the optimal anti-shivering medications is difficult to be finalized. Material and Methods: This study was conducted from May 2019 to May 2020. All age groups and both genders were selected. Data was collected from a tertiary care hospital in Peshawar. It was a prospectively conducted cross-sectional study. Patients were selected having different spinal pathology. They were included based on history, physical examination, and MRI spine. For data analysis, SPSS version 22 software was used. Results: One hundred & fourteen (114) patients were studied. Among these patients, 34 patients (30 %) developed post anaesthesia shivering. Out of these 34 patients, 19 (56 %) were males and 14 (44 %) were females. In all thirty-four patients, Tramadol was used. It was effective in 28 patients (82 %) patients to control PAS. Only six patients (18 %) did not respond to Tramadol. Conclusion: 30 % of the sample population developed PAS. Tramadol is effective in controlling post-anaesthesia shivering and can be used as a favourable alternative to Pethidine whose availability is limited. [ABSTRACT FROM AUTHOR]

Objective. To evaluate the incidence and effectiveness of ondansetron and metoclopramide in prevention and treatment of postoperative nausea and vomiting (PONV)after elective spinal surgery. Postoperative nausea and vomiting a common complication after general anesthesia which can be prevented and treated. Complications of this conditioncause higher rates of morbidity and mortality. PONV is a significant complication for neurosurgical patients. There are certain consequences of PONV specific to the laminectomy and fenestration done in prone position, including increased chance of aspiration, hematoma formation and wound site bleeding. Prophylaxis should be instituted in selected cases. It was descriptive cross sectional comparative study. At Anesthesia and Neurosurgery departments, Naseer Teaching Hospital, Peshawar KPK. It was fifteen months study, from February 2018 to May 2019. Materials and Methods Ninety seven (97)subjects of spinal tumors, spinal stenosis and lumbar prolapsed intervertebral disc were included, in whom laminectomy was done under GA. Twenty three (23) subjects developed nausea and vomiting and were selected in our study. Data collection was done and analyzed on SPSS version 22 software. Results. Among ninety seven subjects, fifty two(53.6%) were female and forty five (46.4%) were male with female to male ratio of 1.1:1.The incidence of PONV was 23.71%. Among twenty three patients who developed nausea and vomiting, fourteen(61%) were female and nine(39%) were male with a female to male ratio of 1.5:1. Among these twenty three patients, eleven (47.8%) patients were given metoclopramide intravenously. In nine (81.8%) patients, PONV was completely controlled with metoclopramideand only two (18.2%) patients required other antiemetic drug in combination with metoclopramide. Twelve (52.2%) were put on ondansetron, intravenously. Eleven (91.6%) patients responded and only one (8.4%) patient needed another antiemetic drug for complete control. Conclusion. Individual use of ondansetron or metoclopramide is nearly equally effective in prevention and treatment of PONV in elective laminectomy or fenestration. In some cases, these drugs may not work completely and other antiemetic drug may be required. Prophylactic use of antiemetic drugs can prevent PONV. Mortality and morbidity from PONV has markedly decreased due to availability of better antiemetic agents. [ABSTRACT FROM AUTHOR]