Comparison of Intravenous Ondansetron versus Intravenous Tramadol on Post-Spinal Shivering and Nausea/Vomiting in Cesarean Sections

Sanum Kashif, Faisal Azam, Khalid Mehmood, Saira Tasneem, Asad Shamim, Fawad Alam, Tasneem Alam


Objective: To compare the effect of intravenous ondansetron versus intravenous tramadol on post-spinal shivering and nausea/vomiting in caesarean sections.
Study Design: Prospective comparative study
Place and Duration of study: The study was carried out at Department of Anesthesia, Frontier Corps Hospital Quetta from 2nd July 2019 to 1st November 2019.
Materials and Methods: Ninety patients, who were scheduled for elective cesarean section under spinal anesthesia were randomly allocated to one of three study groups to receive intravenous ondansetron (group O), tramadol (group T) or normal saline/placebo (group P). Intra- and post-operative shivering score, nausea/vomiting score and hemodynamic changes were recorded. Descriptive data was expressed as means and standard deviations (SD). Analysis of variance (ANOVA) and repeated measure analysis were used for continuous parametric variables. Within groups, comparisons were made using the Tukey’s post-hoc analysis.  Chi-square test was used for association of shivering and nausea/vomiting among the groups.
Results: Both groups were comparable for the age and weight. Shivering was reported 0.35±0.59 in ondansetron group 0.73±0.55 in Tramadol group and 1.90±0.84 in Placebo group (p value< 0.001). Postoperative nausea and vomiting (PONV) was reported 0.25±0.53 in ondansetron group 1.04±0.63 in tramadol group and 0.99±0.71 in placebo group (p value<0.001).There was a significant difference in post-spinal shivering and nausea/vomiting in ondansetron (O) group versus tramadol (T) group and placebo group.
Conclusion: The effect of intravenous ondansetron is better than intravenous tramadol in preventing shivering as well as nausea/vomiting.

Key Words: Cesarean Section, Shivering, Nausea/Vomiting, Ondansetron, Spinal Anesthesia, Tramadol.

How to cite this:
Kashif S, Azam F, Mehmood K, Tasneem S, Shamim A, Alam F, Alam T.  Comparison of Intravenous Ondansetron versus Intravenous Tramadol on Post-Spinal Shivering and Nausea/Vomiting In Cesarean Sections. Life and Science. 2020; 1(4): 156-161 .  doi:

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