Print Get Citation Citation Disclaimer: These citations have been automatically generated based on the information we have and it may not be 100% accurate. Please consult the latest official manual style if you have any questions regarding the format accuracy. AMA Citation Pasumarthi K, Chan A. Pasumarthi K, & Chan A Pasumarthi, Keerthana, and Alex Chan. Low-dose ketamine may reduce shivering following spinal anesthesia. 2 Minute Medicine, 5 December 2022. McGraw Hill, 2022. AccessSurgery. https://accesssurgery.mhmedical.com/updatesContent.aspx?gbosid=605740§ionid=273627716APA Citation Pasumarthi K, Chan A. Pasumarthi K, & Chan A Pasumarthi, Keerthana, and Alex Chan. (2022). Low-dose ketamine may reduce shivering following spinal anesthesia. (2022). 2 minute medicine. McGraw Hill. https://accesssurgery.mhmedical.com/updatesContent.aspx?gbosid=605740§ionid=273627716.MLA Citation Pasumarthi K, Chan A. Pasumarthi K, & Chan A Pasumarthi, Keerthana, and Alex Chan. "Low-dose ketamine may reduce shivering following spinal anesthesia." 2 Minute Medicine McGraw Hill, 2022, https://accesssurgery.mhmedical.com/updatesContent.aspx?gbosid=605740§ionid=273627716. Download citation file: RIS (Zotero) EndNote BibTex Medlars ProCite RefWorks Reference Manager Mendeley © Copyright Annotate Clip Autosuggest Results Low-dose ketamine may reduce shivering following spinal anesthesia by Keerthana Pasumarthi, Alex Chan Listen +Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission. +1. Low-dose ketamine was effective in reducing the incidence of shivering following spinal anesthesia compared to tramadol. +Evidence Rating Level: 2 (Good) +Following spinal anesthesia in orthopedic patients, post-spinal shivering is a common complication. Shivering that is untreated can lead to increased wound pain, metabolic demand, oxygen consumption, and ultimately, hemostatic dysfunction. Literature investigating prophylactic agents to improve post-spinal shivering is limited. In this prospective cohort study, 516 patients undergoing orthopedic surgery under spinal anesthesia were divided into two groups: patients receiving an intravenous prophylactic dose of Ketamine or Tramadol prior to anesthesia. Ketamine is a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist which has a role in thermoregulation. Conversely, tramadol is a weak opioid which acts on central monoaminergic pathways and resets the body’s thermoregulatory center. The selected participants were assessed for post-spinal shivering which was graded on a scale of four. The results of this study showed that the incidence of post-spinal shivering was higher in the tramadol group compared to the ketamine group (43.8% vs 28.7%). Low-dose ketamine had a protective effect against developing post-spinal shivering in patients undergoing spinal anesthesia for orthopedic surgery (aOR 0.427, 95%CI 0.28-0.63). Other adverse events such as incidence of nausea and vomiting was significantly higher in the tramadol group. In conclusion, low-dose ketamine as prophylaxis was more effective in reducing incidence of post-spinal shivering compared to tramadol. However, this study still has a few limitations which should be noted. For instance, while post-operative shivering was graded on a scale, this is still a subjective observation. Post-anesthesia shivering may also occur after the allotted observational time of one hour which was not accounted for. Nevertheless, this study does support the use of ketamine as a prophylaxis for post-anesthesia shivering and randomized controlled trials exploring this association in the future could be valuable. +Click to read the study in BMC Anesthesiology +©2022 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.