Efficacy of Intravenous Tramadol and Low Dose Ketamine in Preventionof Post Spinal Anesthesia Shivering in Lower Segment Cesarean Section

Introduction: Shivering is defined as spontaneous, involuntary, and repetitive muscular activity that commonlyoccurs during and after spinal anesthesia (SA). While generally not life-threatening, untreated post-spinalshivering (PSS) can lead to significant complications. These complications include exacerbation of wound pain,delayed wound healing, increased metabolic demand, elevated oxygen consumption, and hemostatic dysfunction.This is particularly concerning for patients with low cardiac reserve or arterial hypoxia.Methodology: In this prospective observational study, 40 patients who are candidates for subarachnoid blockundergoing surgeries with American Society of Anesthesiologist (ASA) I or II, between 18 to 60 years, who arescheduled for lower segment cesarean section . A total of 40 patients were included and divided into two groups:Group K will get low-dose intravenous ketamine (0.2 mg/kg) and Group T will get tramadol (0.5 mg/kg) inpreventing post-spinal shivering in parturient undergoing cesarean delivery under SA.Result: significant reduction in the incidence of shivering in the ketamine group (25%) compared to the tramadolgroup (55%) with a p-value of 0.048.Conclusion: Low-dose intravenous ketamine(0.2mg/kg) is more effective than tramadol(0.5mg/kg) in reducingpost-spinal shivering, with a lower incidence of intraoperative side effects.