{"title":"比较鞘内新斯的明和芬太尼作为脊髓麻醉中高压布比卡因的辅助药物在缓解术后疼痛方面的作用","authors":"Madhuchanda Borah, Mukesh Patir, Esma Antony","doi":"10.22159/ijcpr.2024v16i3.4071","DOIUrl":null,"url":null,"abstract":"Objective: Many adjuvants are used during lumbar spinal anaesthesia for lower limb and abdominal surgeries in day-to-day anaesthesia practice. The objectives of the study are to evaluate the time to onset of sensory and motor block, analgesic effect, and side effects of Neostigmine and Fentanyl as an adjuvant to hyperbaric Bupivacaine in spinal anaesthesia.\nMethods: 80 patients aged 18 to 60 y of either sex, American Society of Anaesthesiologist (ASA) Physical Status I and II, undergoing elective lower limb and abdominal surgeries under lumbar spinal anaesthesia, were randomly divided into two groups-Group N and Group F, with 40 patients each. Group N received 50 µg Neostigmine and Group F received 30 µg Fentanyl with 03 ml of 0.5% hyperbaric Bupivacaine intrathecally. Intraoperative vitals, onset of sensory and motor block, time to first rescue analgesia, and side effects were recorded.\nResults: There was no significant difference in the time to the onset of sensory block, peak sensory block (T6) and motor block in both groups (p-value>0.05). However, the two-segment block regression was slower, and the time to rescue analgesia was delayed in Group N than in Group F (p-value<0.0001). Except for nausea and vomiting, other side effects like hypotension, bradycardia, etc., were not significant and managed successfully.\nConclusion: Both Neostigmine and Fentanyl are safe and effective adjuvant to hyperbaric Bupivacaine in spinal anaesthesia for post-operative analgesic effect. However, due to the higher incidence of nausea and vomiting, the use of Neostigmine as an adjuvant is limited.","PeriodicalId":13875,"journal":{"name":"International Journal of Current Pharmaceutical Research","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"COMPARISON BETWEEN INTRATHECAL NEOSTIGMINE AND FENTANYL AS ADJUVANT TO HYPERBARIC BUPIVACAINE IN SPINAL ANAESTHESIA FOR POST-OPERATIVE PAIN RELIEF\",\"authors\":\"Madhuchanda Borah, Mukesh Patir, Esma Antony\",\"doi\":\"10.22159/ijcpr.2024v16i3.4071\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective: Many adjuvants are used during lumbar spinal anaesthesia for lower limb and abdominal surgeries in day-to-day anaesthesia practice. The objectives of the study are to evaluate the time to onset of sensory and motor block, analgesic effect, and side effects of Neostigmine and Fentanyl as an adjuvant to hyperbaric Bupivacaine in spinal anaesthesia.\\nMethods: 80 patients aged 18 to 60 y of either sex, American Society of Anaesthesiologist (ASA) Physical Status I and II, undergoing elective lower limb and abdominal surgeries under lumbar spinal anaesthesia, were randomly divided into two groups-Group N and Group F, with 40 patients each. Group N received 50 µg Neostigmine and Group F received 30 µg Fentanyl with 03 ml of 0.5% hyperbaric Bupivacaine intrathecally. Intraoperative vitals, onset of sensory and motor block, time to first rescue analgesia, and side effects were recorded.\\nResults: There was no significant difference in the time to the onset of sensory block, peak sensory block (T6) and motor block in both groups (p-value>0.05). However, the two-segment block regression was slower, and the time to rescue analgesia was delayed in Group N than in Group F (p-value<0.0001). Except for nausea and vomiting, other side effects like hypotension, bradycardia, etc., were not significant and managed successfully.\\nConclusion: Both Neostigmine and Fentanyl are safe and effective adjuvant to hyperbaric Bupivacaine in spinal anaesthesia for post-operative analgesic effect. However, due to the higher incidence of nausea and vomiting, the use of Neostigmine as an adjuvant is limited.\",\"PeriodicalId\":13875,\"journal\":{\"name\":\"International Journal of Current Pharmaceutical Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-05-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Current Pharmaceutical Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.22159/ijcpr.2024v16i3.4071\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Current Pharmaceutical Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.22159/ijcpr.2024v16i3.4071","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的:在日常麻醉实践中,下肢和腹部手术的腰椎麻醉使用了许多辅助药物。本研究旨在评估新斯的明和芬太尼作为高压布比卡因的辅助药物在脊髓麻醉中出现感觉和运动阻滞的时间、镇痛效果和副作用。方法:将在腰椎麻醉下接受择期下肢和腹部手术的 80 名年龄在 18 至 60 岁之间、美国麻醉医师协会(ASA)体能状态 I 级和 II 级的男女患者随机分为两组--N 组和 F 组,每组 40 人。N 组接受 50 微克新斯的明,F 组接受 30 微克芬太尼和 03 毫升 0.5%高压布比卡因鞘内注射。记录了术中生命体征、感觉和运动阻滞的发生、首次镇痛抢救时间和副作用:结果:两组患者的感觉阻滞开始时间、感觉阻滞峰值(T6)和运动阻滞时间无明显差异(P 值>0.05)。然而,N 组的两段阻滞回归速度比 F 组慢,且镇痛抢救时间比 F 组延迟(P 值<0.0001)。除恶心和呕吐外,其他副作用如低血压、心动过缓等均不明显,并能成功控制:结论:新斯的明和芬太尼都是脊髓麻醉中高压布比卡因的安全有效的术后镇痛辅助用药。然而,由于恶心和呕吐的发生率较高,新斯的明作为辅助药物的使用受到了限制。
COMPARISON BETWEEN INTRATHECAL NEOSTIGMINE AND FENTANYL AS ADJUVANT TO HYPERBARIC BUPIVACAINE IN SPINAL ANAESTHESIA FOR POST-OPERATIVE PAIN RELIEF
Objective: Many adjuvants are used during lumbar spinal anaesthesia for lower limb and abdominal surgeries in day-to-day anaesthesia practice. The objectives of the study are to evaluate the time to onset of sensory and motor block, analgesic effect, and side effects of Neostigmine and Fentanyl as an adjuvant to hyperbaric Bupivacaine in spinal anaesthesia.
Methods: 80 patients aged 18 to 60 y of either sex, American Society of Anaesthesiologist (ASA) Physical Status I and II, undergoing elective lower limb and abdominal surgeries under lumbar spinal anaesthesia, were randomly divided into two groups-Group N and Group F, with 40 patients each. Group N received 50 µg Neostigmine and Group F received 30 µg Fentanyl with 03 ml of 0.5% hyperbaric Bupivacaine intrathecally. Intraoperative vitals, onset of sensory and motor block, time to first rescue analgesia, and side effects were recorded.
Results: There was no significant difference in the time to the onset of sensory block, peak sensory block (T6) and motor block in both groups (p-value>0.05). However, the two-segment block regression was slower, and the time to rescue analgesia was delayed in Group N than in Group F (p-value<0.0001). Except for nausea and vomiting, other side effects like hypotension, bradycardia, etc., were not significant and managed successfully.
Conclusion: Both Neostigmine and Fentanyl are safe and effective adjuvant to hyperbaric Bupivacaine in spinal anaesthesia for post-operative analgesic effect. However, due to the higher incidence of nausea and vomiting, the use of Neostigmine as an adjuvant is limited.