Comparison of the Efficacy of Intravenous Dexmedetomidine, and Tramadol for Control of Post-Spinal Shivering in Obstetric Patients Undergoing Lower Segment Caesarean Section

Abstract

Objective: To compare the efficacy of intravenous dexmedetomidine and tramadol in controlling post-spinal shivering among obstetric patients undergoing lower segment caesarean section under spinal anesthesia.

Study Design: A randomized clinical trial study
Place and Duration of Study: This study was conducted at the Department of Anesthesia and Intensive Care, Sheikh Zayed Medical College and Hospital, Rahim Yar Khan, Pakistan, from August 2025 to January 2026.

Methods: A total of 142 pregnant women aged 18 to 60 years scheduled for lower segment caesarean section under spinal anesthesia were enrolled and randomly allocated into two equal groups: dexmedetomidine group (n = 71) and tramadol group (n = 71). Patients in the dexmedetomidine group received intravenous dexmedetomidine 0.5 µg/kg, while those in the tramadol group received intravenous tramadol 0.5 mg/kg prior to spinal anesthesia.

Results: Baseline demographic and physiological characteristics were comparable between the two groups. The incidence of post-spinal shivering was significantly lower in the dexmedetomidine group compared with the tramadol group (16.9% vs 38.0%, p = 0.006). The onset of shivering occurred later in the dexmedetomidine group (24.6 ± 5.3 minutes) than in the tramadol group (18.2 ± 6.1 minutes, p < 0.001). Sedation scores were higher in patients receiving dexmedetomidine (p = 0.001).

Conclusion: Intravenous dexmedetomidine demonstrated superior efficacy compared with tramadol in reducing the incidence and severity of post-spinal shivering in obstetric patients undergoing caesarean section.