Perbandingan Tramadol dan Ondansetron Intravena sebagai Terapi Menggigil pada Pasien yang Menjalani Operasi dengan Anestesi Spinal di RSUP Haji Adam Malik Medan

Abstract

Introduction Shivering is one of the complications that often occurs in postoperative patients. With an incidence of 45% it can occur after administration of anesthesia even though the patient is always kept warm during the operation. Hypothermia that occurs after spinal anesthesia is due to the vasodilating effect below the block area and redistribution of body heat from the core to the periphery and restriction from shivering to the muscle mass above the block area. tramadol, fentanyl, ketamine, ondacentron, pethidine. The role of tramadol to treat shivering is by inhibiting norepinephrine re-uptake. Ondansetron is an intrahypothalamic serotonin inhibitor that has a role in temperature regulation, used as an anti-shivering agent by inhibiting 5-hydroxytryptamine reuptake. Method This study used a double blind randomized controlled clinical trial. The study population was patients who underwent surgery under spinal anesthesia in the operating room of the Central Surgical Installation at RSUP.H.Adam Malik Medan. The research subjects were 48 subjects which were divided into 2 groups, namely subjects who received tramadol and subjects who received ondasetron. The degree of shivering in the subjects was assessed using the modified Crossley and Mahajan scale. Since the drug was given during the operation, it was recorded that the duration of shivering disappeared from minutes to 0.1,2,3,5,10,20,30,60 minutes. Results There was a decrease in the degree of shivering in both the tramadol and ondasetron groups and there was no significant difference between the two groups. Conclusion There is no significance difference between tramadol administration and ondasetron in in the treatment of post spinal shivering with the p value of >0.05. Tramadol dan ondasetron administration has been proven as the treatment of shivering without the need of the rescue regiment of intravenous pethidine until the patient arrived in the recovery room