Intramuscular Neostigmine for Accelerating Bladder Emptying after Cesarean Section by Spinal Anesthesia

Objective: To assess the efficacy of intramuscular (IM) neostigmine administration for acceleration of urinary bladder (UB) emptying and prevention of postoperative urine retention (POUR) following cesarean section (CS) performed under spinal anesthesia. Patients and Methods: Randomized controlled trial conducted on pregnant women who were planned to undergo elective CS under spinal anesthesia. All participants were randomly allocated after surgery into 2 groups; neostigmine group who received 0.5 mg IM neostigmine, and placebo group who received IM NaCl 0.9%. The primary outcome measures were time to first voiding after treatment and time to first voiding after catheter removal, and the secondary outcome measures were volume of excreted urine, postvoid residual bladder volume (PVRBV) and catheterization rate. Results: A total of 100 women (50 women in each group) were subjected to final analysis. Time to first voiding after treatment was significantly lower in neostigmine group than in placebo group (266.94 ± 77.53 vs 303.72 ± 64.07 min; P = 0.027). Also, time to first voiding after catheter removal was significantly lower in neostigmine group than in placebo group (214.90 ± 66.53 vs 241.60 ± 61.73 min; P = 0.036). However, there were no significant difference between both groups in volume of excreted urine, PVRBV and catheterization rate. Conclusion: