Abstract Background: Intrathecal administration of various doses of neostigmine has been reported to produce analgesia without neurotoxicity in both animal and human studies. The present study was undertaken to evaluate the efficacy and safety of intrathecal neostigmine for the relief of pain for patients having undergone inguinal herniorrhaphy surgery. Ho Kyung SongMethods: Sixty men scheduled for elective inguinal herniorrhaphy with spinal anaesthesia were randomly allocated to three groups: group I (n=20) received intrathecal (IT) tetracaine 15 mg, group II (n=20) received IT tetracaine 15 mg+ neostigmine 50 μg, and group III (n=20) received IT tetracaine 15 mg+neostigmine 100 μg. The onset of anaesthesia, duration of analgesia, time to use of first rescue analgesics, the overall 24-h VAS pain scores and the incidence of adverse effects were recorded for 24 h postdrug administration. Results: Onset of anaesthesia (time to T6 sensory block) was significantly faster for group II and III patients compared with group I patients. Motor block (time to lift leg) was greatly prolonged for group III patients, with an average of 6.4 h, compared with 4.1 h for group II patients. Group III patients also showed a later onset of postsurgical pain, lower overall 24-h VAS pain score and prolonged time to first rescue analgesics than did group II patients. There was a significantly greater incidence of adverse effects associated with IT neostigmine, especially nausea and vomiting. Conclusion: Our study showed that intrathecal neostigmine at 50 μg or 100 μg enhanced the onset of tetracaine anaesthesia and provided analgesia lasting for 6–9 h, although increased incidences of prolonged motor blockade and nausea or vomiting were noted (). Study Objective: To establish a dose-response curve for the analgesic effect of intrathecal neostigmine in patients undergoing below knee surgery with spinal anesthesia. To assess adverse effects, principally nausea and vomiting. Design: Randomized, double-blind, prospective study. Setting: Teaching hospital. Patients: 60 ASA physical status I and II premedicated patients undergoing orthopedic surgery (tibial or ankle reconstruction). Interventions: Spinal anesthesia was performed at the sitting position, L 3-L 4 interspace, 4 ml final volume, injected at a rate of 1 ml/10 sec. ![]() The control group (CG) received 15 mg hyperbaric bupivacaine 0.5% plus saline. The 25 μg neostigmine group (25NG) received 15 mg hyperbaric bupivacaine plus 25 μg neostigmine; the 50 μg neostigmine group (50NG) received 15 mg hyperbaric bupivacaine plus 50 μg neostigmine; and the 100 μg neostigmine group (100NG) received 15 mg hyperbaric bupivacaine plus 100 μg neostigmine. Aja kona 10-bit rgb codec. Patients were placed supine after the spinal punction. Measurements and Main Results: Time to first rescue analgesics, analgesia, and adverse effects at constant intervals were assessed using the 10 cm visual analog scale (VAS). Intrathecal neostigmine produced a dose-independent reduction in the postoperative rescue analgesic consumption ( p 0.05), and the overall 24-hour VAS pain scores were lowest for patients who had spinal neostigmine ( p. AnesthesiologyEffects of Intrathecal Neostigmine, Bupivacaine. The mechanisms of the effect of intrathecal neostigmine on the splanchnic sympathetic. A study to compare intrathecal bupivacaine and bupivacaine with neostigmine for post operative analgesia in patients undergoing vaginal hysterectomy.
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