INTERATHECAL INJECTION OF NEOSTIGMINE FOR POSTOPERATIVE PAIN REDUCTION
Abstract
Background. Nowadays, important aim of surgical and anesthetic teams is removing of postoperative pain. One way for decreasing of postoperative pain is usage of interathecal injection of neostigmine. Neostigmine is an anticholinesterase drug to reverse the muscle relaxant effects. The main purpose of this study was evaluation the postoperative pain analgesic efficacy and safety of intrathecal neostigmine in patient undergoing below knee surgery with spinal anesthesia.
Methods. In a clinical trial study sixty adult patients in ASA physical Status I or II were randomly divided into two groups. Group one received normal 1 ml normal saline plus 3ml marcaine and another one received 1ml neostigmine (50µg) plus 3ml normal saline intrathecaly. The severity of postoperative pain was measured using a 10 cm visual analogue scale (0 mean no pain, 10 excruciating pain). If visual analogue scale was> 3, the patient requested analgesia.
Findings. The mean time to the first analgesic administration was significantly prolonged by intrathecal neostigmine (10 h) compared to normal saline (4.5 h) (P < 0.001). Hypertension is seen in 2 patients in the neostigmine group but isn't seen in the normal saline (SO). also hypotension is seen only in one patient in the neostigmine group and 4 patients in the normal saline (SO). Four patients in the neostigmine group, one patient in the normal saline (SO) had nausea. In the neostigmine group there isn't any vomiting, sweating, agitation or pruritis.
Methods. In a clinical trial study sixty adult patients in ASA physical Status I or II were randomly divided into two groups. Group one received normal 1 ml normal saline plus 3ml marcaine and another one received 1ml neostigmine (50µg) plus 3ml normal saline intrathecaly. The severity of postoperative pain was measured using a 10 cm visual analogue scale (0 mean no pain, 10 excruciating pain). If visual analogue scale was> 3, the patient requested analgesia.
Findings. The mean time to the first analgesic administration was significantly prolonged by intrathecal neostigmine (10 h) compared to normal saline (4.5 h) (P < 0.001). Hypertension is seen in 2 patients in the neostigmine group but isn't seen in the normal saline (SO). also hypotension is seen only in one patient in the neostigmine group and 4 patients in the normal saline (SO). Four patients in the neostigmine group, one patient in the normal saline (SO) had nausea. In the neostigmine group there isn't any vomiting, sweating, agitation or pruritis.
Keywords
Drug Administration -Intrathecal, Postoperative Complication, Neostigmine