Postoperative analgesic and adverse effects of two low doses of intrathecal neostigmine and its influence on spinal bupivacaine anaesthesia after knee arthroscopy

Azim Honarmand , Mohammad Reza Safavi , Mohammad Reza Habibzadeh
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Abstract

Background

Neostigmine is a spinal analgesic that could be a useful adjunct. This study was conducted to evaluate the postoperative analgesic efficacy and the safety of two low doses of intrathecal (IT) neostigmine in patients undergoing knee arthroscopy under spinal bupivacaine anaesthesia.

Methods

By using a double-blinded study design, 80 patients undergoing knee arthroscopy during spinal anaesthesia were divided into four groups: bupivacaine group (Group B) received 15 mg hyperbaric bupivacaine; bupivacaine + fentanyl group (Group BF) received 15 mg hyperbaric bupivacaine mixed with 25 μg fentanyl; bupivacaine + neostigmine group 1 (Group BN1) received 15 mg hyperbaric bupivacaine mixed with 25 μg neostigmine; bupivacaine + neostigmine group 2 (Group BN2) received 15 mg hyperbaric bupivacaine mixed with 35 μg neostigmine. The postoperative visual analog scale (VAS) and the incidence of adverse effects were recorded for 24 h after administration of study drugs.

Results

VAS scores were significantly lower in group BN2 compared with group B, group BF and group BN1 at 2, 4, 6, 12, and 24 h after operation (P < 0.05). The time to the first patients’ demand for morphine administration after surgery was significantly prolonged in group BN2 compared with group B or group BN1 (P < 0.05). There was no significant difference between four groups in incidence of nausea and vomiting.

Conclusion

Our study showed that IT neostigmine (35 μg) enhanced bupivacaine spinal anaesthesia (15 mg) and produced prolonged postoperative analgesia for about 24 h without producing significant more adverse effects such as nausea and vomiting.

两种低剂量鞘内新斯的明术后镇痛及不良反应及其对膝关节镜术后脊髓布比卡因麻醉的影响
背景:新斯的明是一种脊柱镇痛药,可能是一种有用的辅助药物。本研究旨在评价两种低剂量鞘内新斯的明用于脊柱布比卡因麻醉下膝关节镜手术患者的术后镇痛效果和安全性。方法采用双盲研究设计,将80例脊柱麻醉期间行膝关节镜检查的患者分为4组:布比卡因组(B组)给予15 mg高压布比卡因;布比卡因+芬太尼组(BF组)给予高压布比卡因15 mg混合芬太尼25 μg;布比卡因+新斯的明组1 (BN1组)给予高压布比卡因15 mg混合新斯的明25 μg;布比卡因+新斯的明组2 (BN2组)给予高压布比卡因15 mg +新斯的明35 μg。记录研究药物给药后24 h的术后视觉模拟评分(VAS)及不良反应发生率。结果BN2组患者术后2、4、6、12、24 h的vas评分均显著低于B组、BF组和BN1组(P <0.05)。与B组和BN1组相比,BN2组患者术后第一次需要吗啡的时间明显延长(P <0.05)。四组患者恶心呕吐发生率无显著差异。结论IT新斯的明(35 μg)对布比卡因脊髓麻醉(15 mg)有增强作用,术后镇痛时间延长约24 h,且未明显增加恶心、呕吐等不良反应。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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