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Korean Journal of Anesthesiology 2004;47(5):649-654.
DOI: https://doi.org/10.4097/kjae.2004.47.5.649   
The Effects of Neostigmine added to Ropivacaine for Intravenous Regional Anesthesia.
Kyu Sik Kang, Sung Hak Jung, Ki Ryang Ahn, Chun Suk Kim, Ji Eun Kim, Si Hyun Yoo, Jin Hyung Kwon
Department of Anesthesiology and Pain Medicine, College of Medicine, Soonchunhyang University, Cheonan, Koreaksjsk@schch.co.kr
Neostigmine has been added to local anesthetic regimen for epidural or intrathecal block, and this resulted in prolonged and improved analgesia, but evidence of its benefit in intravenous regional anesthesia (IVRA) is controversial. The purpose of this study was to evaluate the effects of neostigmine added to ropivacaine for IVRA.
Forty patients undergoing hand or forearm surgery were randomly assigned to two groups to receive IVRA: Group I received 40 ml of 0.2% ropivacaine plus 1 ml of normal saline, and group II received 40 ml of 0.2% ropivacaine plus 500microgram (1 ml) of neostigmine. Sensory block onset time, postoperative visual analogue scale (VAS) scores, recovery time from motor block after deflation, mean arterial pressure (MAP), heart rate (HR), and pulse oximeter saturation (SpO2) values were measured. The incidence of side effects was recorded.
Group II had a shorter sensory block onset time, a prolonged motor block recovery time, and lower postoperative VAS scores. No significant difference was found between the two the groups in terms of MAP, HR, SpO2 and side effects.
The addition of neostigmine to ropivacaine in IVRA is believed to be a useful effective method for outpatient arm surgery due to a shortened sensory onset time and improved postoperative analgesia.
Key Words: intravenous regional anesthesia; neostigmine; ropivacain e; visual analogue scales


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