| The Effects of Intrathecal Neostigmine on Postoperative Analgesia in Patients Undergoing Total Knee Replacement. |
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Sang Yoon Cho, Kyo Sang Kim, Mi Kyoung Oh |
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Department of Anesthesiology, College of Medicine, Hanyang University, Seoul, Korea. |
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| Abstract |
BACKGROUND
Intrathecal neostigmine causes analgesia in dose-dependent pattern. This study was designed to examine postoperative analgesia with intrathecal neostigmine in a randomized, blinded trial with tetracaine as the active control in patients undergoing total knee replacement (TKR).
METHODS: Eighty patients scheduled for TKR were divided into seven groups ( Control; no neostigmine, N25, 50, 75, 100, 125 and 150; subarachnoid tetracaine with neostigmine 25, 50, 75, 100, 125 and 150 g, respectively). Postoperatively, patients assessed their pain on a 10-cm visual analog scale (VAS), total analgesic requirement, time to first analgesic rescue medication and side effects were assessed.
RESULTS
Increasing doses of intrathecal neostigmine showed a dose-dependent pattern of analgesia defined by the overall VAS scores, time until first administration of rescue analgesic request, and the number of rescue analgesics (p<0.05). Nausea and vomiting was also increased by increasing doses of intrathecal neostigmine (p<0.05).
CONCLUSIONS
Intrathecal neostigmine with tetracaine produced definitive analgesia in patients undergoing TKR, and neostigmine 75 g resulted in a better analgesic effect with fewer side effects than other doses. |
| Key Words:
Analgesia: postoperative; Anesthetic techniques: spinal; Pharmacology: Neostigmine |
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