Backgrounds: Remifentanil has been reported to cause post-anesthetic shivering (PAS). Higher doses of\nremifentanil reportedly induce more intense PAS. Tramadol, a synthetic opioid that acts at multiple sites, is\nconsidered to be an effective treatment for PAS, but the evidence for its therapeutic benefit after remifentanil\nanesthesia is limited. We investigated the effect of tramadol on the incidence of PAS after remifentanil anesthesia.\nMethods: Sixty-three patients who had undergone upper abdominal surgery under general anesthesia were\nstudied retrospectively. Tramadol was administered at induction of anesthesia. The patients were divided into four\ngroups: HT(+), high dose remifentanil (1ââ?¬â??1.5 Ã?¼g/kg/min) with tramadol; HT(âË?â??), high dose remifentanil without\ntramadol; LT(+), low dose remifentanil (0.15ââ?¬â??0.25 Ã?¼g/kg/min) with tramadol; and LT(âË?â??), low dose remifentanil\nwithout tramadol. We recorded perioperative changes in nasopharyngeal temperature and episodes of PAS on\nemergence from anesthesia.\nResults: The incidences of PAS in both tramadol treatment groups were significantly lower than the groups that\ndid not receive tramadol. Nasopharyngeal temperature after surgery fell significantly more from baseline in the\ntramadol treatment groups compared with the non-treatment groups.\nConclusion: Tramadol administered at induction of anesthesia appears to suppress PAS following remifentanil\nanesthesia.
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