Title: Evaluation of Intrathecal Neostigmine in Different Doses Added to Xylocaine for Post Operative Analgesia
Authors: Dr Sapna Singh, Dr (Col) Banwari Lal Mathur
DOI: http://dx.doi.org/10.18535/jmscr/v4i4.33
Intrathecal (IT) neostigmine has been used as an adjunct to spinal anaesthesia. The purpose of this study was to determine whether a combination of low-dose neostigmine IT would enhance analgesia of xylocaine IT, in patients undergoing lower abdominal and lower limb surgeries under spinal anesthesia. Study was done on 45 patients, who were divided into 6 groups these groups were given neostigmine in various concentrations (.25mg,.5mg &.75mg) along with 5% xylocaine (heavy) IT with control group receiving only IT xylocaine. Hence, Low dose neostigmine (0.25 mg) when added to xylocaine IT enhances duration of analgesia without affecting significantly cardiovascular status, duration of motor paralysis and adverse effects. Thus more and more use of low dose neostigmine as an adjunct to xylocaine (heavy) I.T. is being recommended. Key words: Xylocaine, Neostigmine, Spinal Anaesthesia. 1. SHR Faiz, P Rahimzadeh, M Sakhaei et al. : Anesthetic effects of adding intrathecal neostigmine or magnesium sulphate to bupivacaine in patients under lower extremities surgeries. 2. Journal Research Med. Sci. 2012 Oct; 17(10): 918-922. 3. Jain A, Jain K, Bhardawaj N: Analgesic efficacy of low dose intrathecal neostigmine in combination with fentanyl and bupivacaine for total knee replacement surgery. 4. Journal Anaesthesiol Clin Pharmacol 2012;28:486-90 5. Hood DD, Eisenach JC, Tuttle R. Phase I safety assessment of intrathecal neostigmine methylsulfate in humans, Anaesthesiolgy 1995;82(2):331-43 6. Lauretti GR, Reis MP, Prado WA, Klamt. IG. Dose response study of intrathecal morphine versus intrathecal neostigmine, their combination or placebo for postoperative analgesia in patients undergoing anterior and posterior vaginoplasty. Anaesth Analg 1996 JUN; 82(6): 1182-7. 7. Hood DD, Mallak KA, Eisenach JC, Tong C. Interaction between intrathecal neostigmine and epidural clonidine in human volunteers. Anesthesiology 1996 Aug; 85(2):315-25 8. Yaksh T.L., Marjorie R. Grafe, Shella Malkmus, Michael I-Rathbun and James C. Eisenach: Study on the safety of Chronically administered intrathecal neostigmine methyl-sulphate in rats and dogs. Anesthesiology, V82, No.2 Feb 1995 9. Herve’ Bouaziz MD., Chuanyao Tong, MD. And James C, C. Eisenach: Post operative Analgesia from Intrathecal Neostigmine in sheep. Anaesthesia and Analgesia 1995;80:1140-4 10. Stephen E Abram and Riched P. Winne : Intrathecal Acetyl cholinesterase inhibitors produce analgesia that is synergistic with morphine and clonidine in rats. Anaesthesia and Analgesia 1995;81:501-7.Abstract
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