PMID- 9667344
OWN - NLM
STAT- MEDLINE
DCOM- 19980917
LR  - 20220316
IS  - 0952-8180 (Print)
IS  - 0952-8180 (Linking)
VI  - 10
IP  - 4
DP  - 1998 Jun
TI  - Combined intrathecal fentanyl and neostigmine: therapy for postoperative 
      abdominal hysterectomy pain relief.
PG  - 291-6
AB  - STUDY OBJECTIVE: To evaluate the analgesic action of spinal neostigmine as part 
      of a multimodal analgesic therapy approach including spinal neostigmine and 
      spinal fentanyl for postoperative pain relief DESIGN: Randomized, prospective 
      study. SETTING: Teaching hospital. PATIENTS: 50 ASA physical status I and II 
      patients undergoing abdominal hysterectomy. INTERVENTIONS: Patients were assigned 
      to one of five groups (n = 10) to receive 15 mg bupivacaine plus 1 ml of the test 
      drug intrathecally. The control group (CG) received saline as the test drug, the 
      fentanyl group (FG) received 25 microg fentanyl; the neostigmine group (NG) 
      received 25 microg neostigmine; the fentanyl-neostigmine 10 microg group (FNG10) 
      was given 10 microg fentanyl plus 10 microg neostigmine; and the 
      fentanyl-neostigmine 25 microg group (FNG25) received 25 microg fentanyl plus 25 
      microg neostigmine. Pain and nausea were evaluated using a 10-cm visual analog 
      scale (VAS). MAIN RESULTS: The analgesic consumption, in 24 hours was greatest in 
      CG, next highest in NG, FG, and FNG10 where consumption was the same in the three 
      groups; and least in FNG25 (p < 0.05). The time to first rescue analgesic 
      medication was greatest for FNG25 compared with the other groups (>5 hours 
      compared with 2 to 3 hours; p < 0.05). VAS showed no statistically significant 
      differences for pain impression, intraoperative and postoperative nausea, or 
      occurrence of vomiting (p > 0.05). CONCLUSION: The combination of 25 microg 
      neostigmine with 25 microg fentanyl given intrathecally with 15 mg of hyperbaric 
      bupivacaine delayed postoperative pain and lowered the number of rescue 
      analgesics. Because the better quality of analgesia was obtained with an 
      increased (although not statistically significant difference) incidence of 
      untoward side effects, larger samples should be studied before its routine use is 
      recommended.
FAU - Lauretti, G R
AU  - Lauretti GR
AD  - Department of Surgery, Orthopedics and Traumatology, Hospital das Clinicas, 
      Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil.
FAU - Mattos, A L
AU  - Mattos AL
FAU - Reis, M P
AU  - Reis MP
FAU - Pereira, N L
AU  - Pereira NL
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Clin Anesth
JT  - Journal of clinical anesthesia
JID - 8812166
RN  - 0 (Analgesics, Opioid)
RN  - 3982TWQ96G (Neostigmine)
RN  - UF599785JZ (Fentanyl)
SB  - IM
MH  - Adult
MH  - Analgesics, Opioid/*therapeutic use
MH  - Analysis of Variance
MH  - Drug Therapy, Combination
MH  - Female
MH  - Fentanyl/*therapeutic use
MH  - Humans
MH  - Hysterectomy/*adverse effects/methods
MH  - Injections, Spinal
MH  - Middle Aged
MH  - Neostigmine/*therapeutic use
MH  - Pain Measurement
MH  - Pain, Postoperative/*drug therapy
MH  - Prospective Studies
EDAT- 1998/07/17 00:00
MHDA- 1998/07/17 00:01
CRDT- 1998/07/17 00:00
PHST- 1998/07/17 00:00 [pubmed]
PHST- 1998/07/17 00:01 [medline]
PHST- 1998/07/17 00:00 [entrez]
AID - S0952-8180(98)00030-0 [pii]
AID - 10.1016/s0952-8180(98)00030-0 [doi]
PST - ppublish
SO  - J Clin Anesth. 1998 Jun;10(4):291-6. doi: 10.1016/s0952-8180(98)00030-0.