Efficacy of preoperative hydrocortisone versus tramadol for attenuation of postoperative shivering after percutaneous nephrolithotripsy: A randomized controlled trial

BackgroundPercutaneous nephrolithotripsy is a technique used for the treatment of renal stones during which an irrigation fluid is used which may cause hypothermia and shivering if not prevented. The aim of this prospective randomized placebo controlled double blinded study was designed to evaluate the efficacy of preoperative hydrocortisone versus tramadol for attenuation of postoperative shivering after percutaneous nephrolithotripsy under general anesthesiaMethod90 ASA I males and females patients aged 20–50 years, planned for percutaneous nephrolithotripsy under general anesthesia were randomly divided into three groups:Group S (n = 30) received 10 ml normal saline IV before induction of general anesthesiaGroup H (n = 30) received IV hydrocortisone 2 mg/kg before induction of general anesthesiaGroup T (n = 30) received IV tramadol hydrochloride 1 mg/kg before induction of general anesthesiaThe following parameters were recorded:Core temperature, heart rate and mean arterial blood pressure before induction of anesthesia, then every 15 min after induction of anesthesia, and every 30 min in the PACU, shivering intensity in the first 2 h postoperative, the incidence of shivering, the number of patients required meperidine and side effects.ResultsThe number of patients who had shivering was statistically significantly higher in S group (12) than in H group (8) and in T group (7) with no statistically significant differences between H and T groups.Intraoperative heart rate, mean arterial blood pressure and side effects showed no statistically significant difference between the study groups.ConclusionPreoperative IV hydrocortisone and tramadol were effective in attenuation of postoperative shivering compared to placebo after percutaneous nephrolithotripsy without increasing the incidence of side effects.