COMPARING PROPHYLACTIC EFFECTIVENESS OF PETHIDINE, TRAMADOL AND KETAMINE FOR PREVENTION OF SHIVERING FOLLOWING SPINAL ANESTHESIA FOR PARTURIENT UNDERGOING ELECTIVE CAESARIAN SECTION AT HAWASSA UNIVERSITY COMPREHENSIVE SPECIALIZED HOSPITAL, HAWASSA, E

Abstract Background: Shivering is one of the commonest complications following spinal anesthesia (SA) is 50 65%. The incidence of shivering following SA for caesarian section(C/S) reported to be 40-55% that can impose physiologic, physical and psychology problem on parturient. In most operating theater and post anesthesia care unit, shivering controlled by using pharmacologic modality. However, the therapeutic superiority remains understudied. Objective: To compare prophylactic effectiveness of Pethidine, Tramadol and Ketamine for prevention of shivering following SA for parturient undergoing elective C/S at Hawassa Comprehensive Specialized Hospital, Ethiopia Methodology: In three groups of drugs, parallel-randomized control trial study conducted on 150 parturient who underwent elective CS; They were randomized to three groups group A (Pethidine 0.5 mg/kg), group B (Tramadol 0.5 mg/kg) and group C (Ketamine 0.2 mg/kg). The outcome of the study was incidence of shivering, severity of shivering and side effect drugs during follow up period. After normality checked using Skewness-Kurtosis Z-value test and Shapiro-Wilk test, parametric data analyzed using ANOVA and categorical variable using chi-square test. Statically significances stated at P value less than 0.05. Table and chart used to show the data. Result presented with percentage and mean ±SD. Result: The proportion of intra-operative shivering between group higher in Tramadol 16% than Pethidine 8% and Ketamine 10 % but no statically significance( p=0.422). In addition postoperative the proportion of shivering was lower in Ketamine group 12% compared with Pethidine 18% and Tramadol 20% (p= 0.536). Regarding severity of shivering there were no statically significance difference between groups (p= 0.539 and p=0.716) respectively during intraoperative and postoperative period. Moreover, intraoperative proportion of N/V were Pethidine 20%, Tramadol 24% and Ketamine 0% (p=0.002), N/V has statically significance difference between groups. However, incidence of sedation no statically significance difference between the group (p=0.536).Finally, in postoperative period proportion N/V were in Pethidine 8%, in Tramadol 2% and in Ketamine 0 (p=0.108). Conclusion and Recommendation: There is no difference between the groups of drugs in prevention of shivering. However, drug associated N/V were lesser with Ketamine group. We recommend that Pethidine, Ketamine or Tramadol are equally effective in prevention of perioperative shivering following C/S under SA.