Indian Journal of Public Health Research & Development

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A Pilot Study of the Efficacy of Intrathecal Neostigmine for Postoperative Analgesia in Lower Abdominal and Lower Limb Surgery at SIMS, Ghaziabad, Uttar Pradesh


Affiliations
1 Department of Anaesthesia, Sarswathi Institute of Medical Sciences, NH-24 Anwarpur, Hapur, Ghaziabad 245304, India
     

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Intrathecal neostigmine had been used in various doses to produce analgesia without neurotoxicity in both animal and human studies. The present study was conducted using 50μg intrathecal neostigmine methylsulphate with 12.5mg bupivacaine (0.5% heavy) for optimum duration of post-operative analgesia with minimal side effects. In this study 100 patients belonging to ASA physical status I and II, age 20-70 years of either sex scheduled for elective lower abdominal and lower limb surgeries under spinal anaesthesia were included. Patients were randomly allocated in two groups: group I (n=50, control) received 2.5ml bupivacaine + 0.5ml of normal saline and group II (n=50, test) received 2.5ml bupivacaine +0.5ml of neostigmine (50μg). Time of onset of sensory and motor block, highest level of block, duration of analgesia and side effects like hypotension, bradycardia, nausea, vomiting, etc were recorded. Onset time of sensory and motor block was much faster In bupivacaine and neostigmine group as compared to bupivacaine group. Patients were pain free for average 6-7 hours with bupivacaine and neostigmine as compared to 3-4 hours with bupivacaine. It was concluded that intrathecal neostigmine in the dose of 50μg provide post-operative analgesia for a period of 6-8 hours with lesser incidence of side effects of nausea and vomiting.

Keywords

Anaesthesia, Spinal Anaesthesia, Drugs, Bupivacaine, Neostigmine
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  • A Pilot Study of the Efficacy of Intrathecal Neostigmine for Postoperative Analgesia in Lower Abdominal and Lower Limb Surgery at SIMS, Ghaziabad, Uttar Pradesh

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Authors

Sharad Goel
Department of Anaesthesia, Sarswathi Institute of Medical Sciences, NH-24 Anwarpur, Hapur, Ghaziabad 245304, India
Ritu Goyal
Department of Anaesthesia, Sarswathi Institute of Medical Sciences, NH-24 Anwarpur, Hapur, Ghaziabad 245304, India
Sanjay Lal
Department of Anaesthesia, Sarswathi Institute of Medical Sciences, NH-24 Anwarpur, Hapur, Ghaziabad 245304, India
Shailja Sharma
Department of Anaesthesia, Sarswathi Institute of Medical Sciences, NH-24 Anwarpur, Hapur, Ghaziabad 245304, India

Abstract


Intrathecal neostigmine had been used in various doses to produce analgesia without neurotoxicity in both animal and human studies. The present study was conducted using 50μg intrathecal neostigmine methylsulphate with 12.5mg bupivacaine (0.5% heavy) for optimum duration of post-operative analgesia with minimal side effects. In this study 100 patients belonging to ASA physical status I and II, age 20-70 years of either sex scheduled for elective lower abdominal and lower limb surgeries under spinal anaesthesia were included. Patients were randomly allocated in two groups: group I (n=50, control) received 2.5ml bupivacaine + 0.5ml of normal saline and group II (n=50, test) received 2.5ml bupivacaine +0.5ml of neostigmine (50μg). Time of onset of sensory and motor block, highest level of block, duration of analgesia and side effects like hypotension, bradycardia, nausea, vomiting, etc were recorded. Onset time of sensory and motor block was much faster In bupivacaine and neostigmine group as compared to bupivacaine group. Patients were pain free for average 6-7 hours with bupivacaine and neostigmine as compared to 3-4 hours with bupivacaine. It was concluded that intrathecal neostigmine in the dose of 50μg provide post-operative analgesia for a period of 6-8 hours with lesser incidence of side effects of nausea and vomiting.

Keywords


Anaesthesia, Spinal Anaesthesia, Drugs, Bupivacaine, Neostigmine

References