The goal of this clinical trial is to compare the effectiveness of tramadol versus ketamine in preventing shivering after spinal anesthesia in adult patients (ages 20-65) undergoing elective lower abdominal or inguinoscrotal surgeries. The main questions it aims to answer are: * Does prophylactic intravenous tramadol reduce the incidence and severity of shivering more effectively than ketamine after spinal anesthesia? * Are there differences in side effects, such as sedation or nausea, between tramadol and ketamine? Researchers will compare the tramadol group to the ketamine group to see which drug is more effective and safer for shivering prevention. Participants will: * Be randomly assigned to receive either tramadol (1 mg/kg) or ketamine (0.5 mg/kg) five minutes after spinal anesthesia. * Have their shivering severity assessed at 15, 30, 45, and 60 minutes using a standardized scale. * Be monitored for sedation, nausea, and other possible side effects.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
92
Tramadol 1 mg/kg IV given 5 minutes after spinal anesthesia for prevention of post-anesthesia shivering
Ketamine 0.5 mg/kg IV administered 5 minutes after spinal anesthesia for prevention of post-anesthesia shivering.
Sindh Institute of Urology and Transplantation
Karachi, Sindh, Pakistan
Syed Muhammad Abbas
Karachi, Sindh, Pakistan
Incidence and Severity of Post-Spinal Anesthesia Shivering
The incidence and severity of shivering will be assessed using the Bedside Shivering Assessment Scale (BSAS) at 15, 30, 45, and 60 minutes following the administration of spinal anesthesia. BSAS Grading: * 0 = No shivering * 1 = Piloerection or peripheral vasoconstriction without visible shivering * 2 = Visible muscular activity confined to one muscle group * 3 = Gross muscular activity involving the entire body
Time frame: Up to 60 minutes post spinal anesthesia
Sedation Score
Sedation will be measured using the Ramsay Sedation Scale (RSS) at 15, 30, 45, and 60 minutes post spinal anesthesia. RSS scores range from 1 (anxious, agitated) to 6 (no response). Median and interquartile ranges will be calculated for each group.
Time frame: Up to 60 minutes post spinal anesthesia
Incidence of Postoperative Nausea and Vomiting (PONV)
PONV will be assessed using the PONV Impact Scale at 15, 30, 45, and 60 minutes post spinal anesthesia. Presence or absence will be recorded at each time point.
Time frame: Up to 60 minutes post spinal anesthesia
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