The Effects of Intrathecal Neostigmine on Postoperative Analgesia in Patients Undergoing Total Knee Replacement.
10.4097/kjae.1998.34.1.121
- Author:
Sang Yoon CHO
1
;
Kyo Sang KIM
;
Mi Kyoung OH
Author Information
1. Department of Anesthesiology, College of Medicine, Hanyang University, Seoul, Korea.
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Analgesia: postoperative;
Anesthetic techniques: spinal;
Pharmacology: Neostigmine
- MeSH:
Analgesia*;
Analgesics;
Arthroplasty, Replacement, Knee*;
Humans;
Nausea;
Neostigmine*;
Tetracaine;
Visual Analog Scale;
Vomiting
- From:Korean Journal of Anesthesiology
1998;34(1):121-125
- CountryRepublic of Korea
- Language:Korean
-
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.
