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Analgesic effects of intrathecal neostigmine in perianal surgery

Published online by Cambridge University Press:  30 June 2005

A. Yegin ,
M. Yilmaz ,
B. Karsli  and
M. Erman
A. Yegin
Affiliation:
Akdeniz University Faculty of Medicine, Department of Anaesthesiology, Antalya, Turkey
M. Yilmaz
Affiliation:
Akdeniz University Faculty of Medicine, Department of Anaesthesiology, Antalya, Turkey
B. Karsli
Affiliation:
Akdeniz University Faculty of Medicine, Department of Anaesthesiology, Antalya, Turkey
M. Erman
Affiliation:
Akdeniz University Faculty of Medicine, Department of Anaesthesiology, Antalya, Turkey
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Extract

Summary

Background and objective: In recent human and animal studies, intrathecal administration of various doses of neostigmine produces analgesia without neurotoxicity. The aim was to examine the effects of intrathecal neostigmine and bupivacaine in patients undergoing perianal surgery under spinal anaesthesia.

Methods: The patients were randomly allocated into three groups of 15: Group 1 (controls) received hyperbaric bupivacaine 10 mg + dextrose 5%, 1 mL, to a total volume of 3 mL; Group 2 received hyperbaric bupivacaine 10 mg + neostigmine 25 μg in dextrose 5%, 1 mL, to a total volume of 3 mL; and Group 3 received hyperbaric bupivacaine 10 mg + neostigmine 50 μg in dextrose 5%, 1 mL, to a total volume of 3 mL.

Results: The onset of sensory block was significantly earlier for Group 2 and 3 patients compared with Group 1 patients (P < 0.05). The full time to recovery of motor block and sensory block was significantly longer in Group 3 compared with Group 1 (P < 0.05). In Group 3, the average time until the first dose of tramadol was longer than Group 1 (P < 0.05). The incidence rate of nausea and vomiting was significantly higher in Groups 2 and 3 than in Group 1 (P < 0.05).

Conclusions: The use of intrathecal neostigmine as an analgesic drug in perianal surgery is unsatisfactory because of prolonged motor blockade and nausea.

Keywords

ANAESTHESIA, CONDUCTION, anaesthesia spinal, CHOLINESTERASE INHIBITORS, neostigminePOSTOPERATIVE COMPLICATIONS, pain postoperativePOSTOPERATIVE NAUSEA AND VOMITING
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 5 , May 2003 , pp. 404 - 408
Copyright
2003 European Society of Anaesthesiology

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