Abstract :
Introduction: Shivering is a very common complaint in many patients intra-operatively after spinal
anaesthesia. The reasons for shivering are multiple. Several measures are taken to prevent and control
shivering under spinal anaesthesia. These measures include pharmacological and non- pharmacological
intervention. Pharmacological intervention is an effective method to control shivering under spinal
anaesthesia because the drugs for controlling shivering are easily available and it is cost effective. The
present study was planned to compare effectiveness of two drugs: Butorphanol and Clonidine which were
given intravenously to control shivering under spinal anaesthesia.
Material and Methods: The design of study was randomized and double blind. It included total of
60 patients of ASA I/II physical status. These patients were posted for elective surgeries under spinal
anaesthesia; which included lower abdominal, urological and lower limb surgeries. Among these; patients
who developed shivering of Grade 3 or 4 intra-operatively were included in our study. These patients
were randomly divided into two groups: Group C and Group B. Each group included 30 patients. Group
C patients were given Clonidine 1 mg /Kg and Group B patients were given Butorphanol 0.03 mg/Kg
intravenously. The drugs were given after patient developed shivering of grade 3 / 4 intra-operatively
during spinal anaesthesia. Time needed for control of shivering; whether complete or incomplete control
of shivering, side effects of drugs and recurrence of shivering were observed and noted.
Results: The study groups were comparable with respect to demographic profile, duration of surgery and
mean time for onset of shivering. Time required for control of shivering was more with Clonidine (331.33
70.65 seconds) as compared to Butorphanol (81.1737.38 seconds). The incidence of recurrence was
significantly more with Clonidine as compared to Butorphanol (P< 0> such as hypotension and bradycardia was significantly higher with Clonidine as compared to Butorphanol.
The incidence of sedation was not statistically significant between two groups.
Conclusion: Butorphanol is better than Clonidine for control of shivering which occurs intra-operatively
under spinal anaesthesia. The advantages of Butorphanol are faster control with lower incidence of
recurrence of shivering and lower incidence of side effects such as hypotension and bradycardia.
Keyword :
Butorphanol, Clonidine, Spinal anaesthesia, Shivering.