Analgesic effect of epidural neostigmine after abdominal hysterectomy.

Abstract

STUDY OBJECTIVE:

To evaluate the effects of epidurally administered neostigmine on pain after abdominal hysterectomy.

DESIGN:

Prospective, randomized, double-blind study.

SETTING:

Teaching hospital.

PATIENTS:

45 ASA physical status I adult patients scheduled for abdominal hysterectomy.

INTERVENTIONS:

All patients received identical general and epidural anesthesia. At the end of the surgery, they received epidural bupivacaine (10 mg) with either saline (control group, n = 15), 5 micro g/kg (5-micro g group, n = 15), or 10 micro g/kg neostigmine (10-micro g group, n = 15). Postoperatively, 50 mg diclofenac suppository was given for pain relief on patient demand.

MEASUREMENTS AND MAIN RESULTS:

The time to first diclofenac administration and the number of times diclofenac was required during the first 24 postoperative hours were recorded. Pain was assessed using a 10-cm visual analog pain scale (VAS) at rest at the first diclofenac request, and at 15 and 24 hours after surgery. The time to first diclofenac administration was significantly longer (p < 0.05) in the 10-micro g group (223 +/- 15 min) than in the control (78 +/- 17 min) or 5-micro g groups (88 +/- 18 min). However, epidural neostigmine at both doses did not reduce the number of postoperative diclofenac administrations. There were no differences in VAS among the three groups.

CONCLUSIONS:

Epidural neostigmine of 10 micro g/kg in bupivacaine provides a longer duration of analgesia than does bupivacaine alone or with 5 micro g/kg of neostigmine after abdominal hysterectomy.

• Authors: M Nakayama, H Ichinose, K Nakabayashi, O Satoh, S Yamamoto, A Namiki
• Journal: Journal of clinical anesthesia (J Clin Anesth) Vol. 13 Issue 2 Pg. 86-9 (Mar 2001) ISSN: 0952-8180 [Print] United States
• PMID: 11331165 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Cholinesterase Inhibitors
• Diclofenac
• Neostigmine

Topics

• Analgesia, Epidural
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Cholinesterase Inhibitors (adverse effects, therapeutic use)
• Diclofenac (therapeutic use)
• Double-Blind Method
• Female
• Humans
• Hysterectomy
• Male
• Middle Aged
• Neostigmine (adverse effects, therapeutic use)
• Pain Measurement (drug effects)
• Pain, Postoperative (drug therapy)
• Preanesthetic Medication
• Prospective Studies