Mitigating Post-Spinal Anesthesia Shivering by Exploring Intravenous Ketamine vs. Intravenous Tramadol and Comparison of the Optimal Dose of Ketamine: A Scoping Review of Cohort and Randomized Controlled Trials Studies

Background: Shivering is prevalent in 65% of patients undergoing spinal anesthesia, resulting in adverse outcomes and increased healthcare expenses. Ketamine, an N-methyl-D-aspartate receptor antagonist, and tramadol exhibit analgesic properties, potentially mitigating post-spinal shivering. This s...

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Main Authors: Siavash Sangi, Mehrdad Mesbah Kiaei, Maryam Aligholizadeh, Alireza Babajani, Parisa Akbarpour, Maryam Sarkhosh, Elnaz Jalalkamali, Zahra Karimian
Format: Article
Language:English
Published: Tehran University of Medical Sciences 2024-12-01
Series:Archives of Anesthesia and Critical Care
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Online Access:https://aacc.tums.ac.ir/index.php/aacc/article/view/1081
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author Siavash Sangi
Mehrdad Mesbah Kiaei
Maryam Aligholizadeh
Alireza Babajani
Parisa Akbarpour
Maryam Sarkhosh
Elnaz Jalalkamali
Zahra Karimian
author_facet Siavash Sangi
Mehrdad Mesbah Kiaei
Maryam Aligholizadeh
Alireza Babajani
Parisa Akbarpour
Maryam Sarkhosh
Elnaz Jalalkamali
Zahra Karimian
author_sort Siavash Sangi
collection DOAJ
description Background: Shivering is prevalent in 65% of patients undergoing spinal anesthesia, resulting in adverse outcomes and increased healthcare expenses. Ketamine, an N-methyl-D-aspartate receptor antagonist, and tramadol exhibit analgesic properties, potentially mitigating post-spinal shivering. This scoping review aims to explore the existing literature on the intravenously administered ketamine and tramadol in reducing the incidence of shivering subsequent to spinal anesthesia. Methods: This scoping review, conducted from April to June 2024, examined studies on intravenous ketamine and tramadol for shivering post-spinal anesthesia. Using MeSH terms, researchers searched Scopus, Web of Science, PubMed, Cochrane, Google Scholar, Iran SID, and Iran ISC. After excluding duplicates and irrelevant studies, six pertinent studies were included. Results: The search strategy identified 1316 articles, with 1258 remaining after removing 58 duplicates. Title and abstract screening excluded 6 conference papers, 42 systematic reviews, 94 book chapters or animal studies, and 2 theses. A full-text review of 97 studies resulted in excluding 78 unrelated cases, 1 language discrepancy, and 11 without full-text availability. Ultimately, 6 studies (5 randomized controlled trials and 1 prospective cohort) from Iran, Pakistan, India, Egypt, and Ethiopia found ketamine more effective than tramadol in preventing shivering. Conclusion: Ketamine is more effective than tramadol in preventing post-spinal anesthesia shivering, with fewer adverse effects like nausea, vomiting, and bradycardia. These findings support its use for shivering management. Future research should optimize dosing to reduce hallucinations, explore other side effects, and prioritize diverse study parameters and safety evaluations.
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spelling doaj-art-4a5e243cc63a4e2c9193971f81632d9b2025-08-20T01:49:08ZengTehran University of Medical SciencesArchives of Anesthesia and Critical Care2423-58492024-12-0111310.18502/aacc.v11i3.18506Mitigating Post-Spinal Anesthesia Shivering by Exploring Intravenous Ketamine vs. Intravenous Tramadol and Comparison of the Optimal Dose of Ketamine: A Scoping Review of Cohort and Randomized Controlled Trials StudiesSiavash Sangi0Mehrdad Mesbah Kiaei1Maryam Aligholizadeh2Alireza Babajani3Parisa Akbarpour4Maryam Sarkhosh5Elnaz Jalalkamali6Zahra Karimian7Anesthesia and Operating Room Department, Nursing and Midwifery Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Department of Anesthesiology and Pain Medicine, Hasheminejad Kidney Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.Anesthesia and Operating Room Department, Nursing and Midwifery Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Department of Anesthesia Technology, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran.Department of Anesthesia Technology, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran.Department of Anesthesia Technology, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran.Department of Anesthesia Technology, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran.Anesthesia and Operating Room Department, Nursing and Midwifery Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Background: Shivering is prevalent in 65% of patients undergoing spinal anesthesia, resulting in adverse outcomes and increased healthcare expenses. Ketamine, an N-methyl-D-aspartate receptor antagonist, and tramadol exhibit analgesic properties, potentially mitigating post-spinal shivering. This scoping review aims to explore the existing literature on the intravenously administered ketamine and tramadol in reducing the incidence of shivering subsequent to spinal anesthesia. Methods: This scoping review, conducted from April to June 2024, examined studies on intravenous ketamine and tramadol for shivering post-spinal anesthesia. Using MeSH terms, researchers searched Scopus, Web of Science, PubMed, Cochrane, Google Scholar, Iran SID, and Iran ISC. After excluding duplicates and irrelevant studies, six pertinent studies were included. Results: The search strategy identified 1316 articles, with 1258 remaining after removing 58 duplicates. Title and abstract screening excluded 6 conference papers, 42 systematic reviews, 94 book chapters or animal studies, and 2 theses. A full-text review of 97 studies resulted in excluding 78 unrelated cases, 1 language discrepancy, and 11 without full-text availability. Ultimately, 6 studies (5 randomized controlled trials and 1 prospective cohort) from Iran, Pakistan, India, Egypt, and Ethiopia found ketamine more effective than tramadol in preventing shivering. Conclusion: Ketamine is more effective than tramadol in preventing post-spinal anesthesia shivering, with fewer adverse effects like nausea, vomiting, and bradycardia. These findings support its use for shivering management. Future research should optimize dosing to reduce hallucinations, explore other side effects, and prioritize diverse study parameters and safety evaluations. https://aacc.tums.ac.ir/index.php/aacc/article/view/1081ShiveringKetamineTramadolSpinal AnesthesiaScoping Review
spellingShingle Siavash Sangi
Mehrdad Mesbah Kiaei
Maryam Aligholizadeh
Alireza Babajani
Parisa Akbarpour
Maryam Sarkhosh
Elnaz Jalalkamali
Zahra Karimian
Mitigating Post-Spinal Anesthesia Shivering by Exploring Intravenous Ketamine vs. Intravenous Tramadol and Comparison of the Optimal Dose of Ketamine: A Scoping Review of Cohort and Randomized Controlled Trials Studies
Archives of Anesthesia and Critical Care
Shivering
Ketamine
Tramadol
Spinal Anesthesia
Scoping Review
title Mitigating Post-Spinal Anesthesia Shivering by Exploring Intravenous Ketamine vs. Intravenous Tramadol and Comparison of the Optimal Dose of Ketamine: A Scoping Review of Cohort and Randomized Controlled Trials Studies
title_full Mitigating Post-Spinal Anesthesia Shivering by Exploring Intravenous Ketamine vs. Intravenous Tramadol and Comparison of the Optimal Dose of Ketamine: A Scoping Review of Cohort and Randomized Controlled Trials Studies
title_fullStr Mitigating Post-Spinal Anesthesia Shivering by Exploring Intravenous Ketamine vs. Intravenous Tramadol and Comparison of the Optimal Dose of Ketamine: A Scoping Review of Cohort and Randomized Controlled Trials Studies
title_full_unstemmed Mitigating Post-Spinal Anesthesia Shivering by Exploring Intravenous Ketamine vs. Intravenous Tramadol and Comparison of the Optimal Dose of Ketamine: A Scoping Review of Cohort and Randomized Controlled Trials Studies
title_short Mitigating Post-Spinal Anesthesia Shivering by Exploring Intravenous Ketamine vs. Intravenous Tramadol and Comparison of the Optimal Dose of Ketamine: A Scoping Review of Cohort and Randomized Controlled Trials Studies
title_sort mitigating post spinal anesthesia shivering by exploring intravenous ketamine vs intravenous tramadol and comparison of the optimal dose of ketamine a scoping review of cohort and randomized controlled trials studies
topic Shivering
Ketamine
Tramadol
Spinal Anesthesia
Scoping Review
url https://aacc.tums.ac.ir/index.php/aacc/article/view/1081
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