Browsing by Author "Dagne Meskerem"

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    Effectiveness of Preoperative Oral Tramadol in Preventing Perioperative Shivering in Geriatric Patients for Transurethral Resection of Prostate Surgery Under Spinal Anesthesia.
    (Addis Ababa University, 2019-06) Dagne Meskerem; Girma Betelihem; Haddis Lidya
    Background: Spinal anesthesia is widely used as a safe anesthesia technique for both elective and emergency surgeries. Shivering is a frequent complication, distressing for the patients undergoing surgery under both regional and general anesthesia. Regional anesthesia has been known to be associated with greater heat loss than general anesthesia. Post anesthetic shivering may cause discomfort to patients, and aggravate wound pain by stretching incisions and increase intracranial and intraocular pressure. Shivering increase tissue oxygen demand by as much as 500% and accompanied by increase in minute ventilation and cardiac output to maintain aerobic metabolism. Elderly patients are especially at risk of hypothermia under anesthesia, as low core temperatures may not initiate autonomic protective response. Objective: To assess the effectiveness of oral tramadol in preventing perioperative shivering in patients undergoing TURP surgery at Hawassa university comprehensive specialized hospital from February to May 2019 GC. Method: A prospective cohort study design was employed. Sample size was calculated by using double proportion formula with equal sample size where n1=sample for oral tramadol group, n2=sample for control group and the final Sample size became n1= n2=30 A systemic random sampling technique was used to select study participants. Data was collected by using structured questionnaire. Based on normality assumption, analysis was done by independent sample t test, χ2 ,Mann–Whitney U-test and Kaplan meier as appropriate. P value <0.05 was considered as statistically significant. Result: The incidence of shivering was significantly less in patients who received preoperative oral tramadol group than those of control group. (13.3% vs. 80%, p<0.001).Grades of shivering were also significantly different with only grades 1-3 in oral tramadol compared to 2-4 grades of shivering revealed in those who didn’t took it with p=0.006. Patients who didn’t took oral tramadol experience shivering in the first 20 minutes after spinal anesthesia performed when compared to tramadol groups with log rank test -p=0.015 . Conclusion and Recommendation: our study demonstrate that taking 50 mg oral tramadol before two hours of the operation time was effective to decrease the incidence, severity and delay the onset of shivering which occur after spinal anesthesia for geriatric patients who undergo transurethral resection of prostate surgery. Based on this we recommend that oral tramadol is one of widely available drug in our country. So ordering it as perioperative shivering prophylaxis is a good option to improve the clinical quality of our patient management.