Evaluating the Effectiveness of Nefopam Versus Tramadol in Treating Established Post-Spinal Anesthesia Shivering: A Systematic Review
Notice bibliographique
Résumé
Background: Post-spinal anesthesia shivering (PSAS) was observed as a frequent and distressing complication, affecting 40–70% of patients and increasing metabolic demand. Nefopam and tramadol were two pharmacological agents for managing PSAS. Each had its distinct efficacy and side effect profiles. This study evaluated and compared the efficacy, safety, and practicality of nefopam and tramadol in the treatment of established PSAS. Methods: A systematic review was conducted that adhered to PRISMA guidelines. The search took place using PubMed, ScienceDirect, and Google Scholar. Inclusion criteria focused on randomized controlled trials and observational studies published between January 2013 and April 2024. The studies were excluded if they were not based on tramadol and nefopam’s therapeutic effect on PSAS. Data for the systematic review table were extracted from 16 studies evaluating sedation quality, recovery time, adverse events, and key findings. The Cochrane risk of bias tool was used for RCTs, and the Newcastle Ottawa tool was used for observational studies to assess the risk of bias. Sedation quality was assessed by a visual analog scale (VAS). Results: Out of 110 initially selected studies, 16 were filtered out that aligned completely with the concept of this systematic review. Both nefopam and tramadol were shown to reduce PSAS. Tramadol demonstrated a slightly higher efficacy (90–97%) compared to nefopam (85–90%). Tramadol, due to its rapid onset (30–60 minutes) and faster recovery times, was suitable for time-sensitive cases. However, tramadol had a higher incidence of gastrointestinal side effects (nausea and vomiting: 5–11%). In contrast, nefopam, while slower in showing effect, exhibited minimal sedation and fewer side effects but occasionally caused tachycardia and hypertension. Discussion: Both agents were effective for PSAS management. Tramadol was preferred for rapid control and cost-friendly settings, whereas nefopam was safer for patients who required minimal sedation or who were at risk of gastrointestinal side effects. However, there was no direct comparison of nefopam with tramadol. Future studies should focus on using standardized protocols and should provide a direct comparison of tramadol with nefopam.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,010 | 0,011 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,005 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».