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Intrathecal Bupivacaine with Neostigmine and Bupivacaine with Normal Saline for Postoperative Analgesia: A Cost-effective Additive

CONTEXT: In day-to-day practice, subarachnoid block remains the most common type of anesthesia. Bupivacaine is commonly used local anesthetic of neuraxial blockade, though earlier 5% xylocaine and now ropivacaine and levobupivacaine are also used. Additives such as opioids and α(2) agonists are also...

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Autores principales: Kumari Vasantha, Naga Seshu, Madhusudhana, Ravi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6020563/
https://www.ncbi.nlm.nih.gov/pubmed/29962592
http://dx.doi.org/10.4103/aer.AER_184_17
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author Kumari Vasantha, Naga Seshu
Madhusudhana, Ravi
author_facet Kumari Vasantha, Naga Seshu
Madhusudhana, Ravi
author_sort Kumari Vasantha, Naga Seshu
collection PubMed
description CONTEXT: In day-to-day practice, subarachnoid block remains the most common type of anesthesia. Bupivacaine is commonly used local anesthetic of neuraxial blockade, though earlier 5% xylocaine and now ropivacaine and levobupivacaine are also used. Additives such as opioids and α(2) agonists are also used. We are using neostigmine as an additive with bupivacaine to see the duration of postoperative analgesia. AIMS: To compare the efficacy of intrathecal hyperbaric bupivacaine with neostigmine when compared to hyperbaric bupivacaine with normal saline with regard to time of onset and duration of sensory and motor blockade, time to two-segment regression. SETTINGS AND DESIGN: Randomized, double-blinded study. SUBJECTS AND METHODS: One hundred patients admitted for lower abdominal and lower limb surgeries done under spinal anesthesia (SA) during the period of February 2015–August 2016. STATISTICAL ANALYSIS USED: Data were entered into Microsoft excel data sheet and analyzed using SPSS 22 version. Categorical data were represented in the form of frequencies and proportions. Chi-square was used as a test of significance. Continuous data were represented as a mean and standard deviation. Independent t-test was used as a test of significance to identify the mean difference between two groups. RESULTS: Mean onset of sensory blockade with neostigmine group was 174.1 ± 107.1 s and in normal saline group 171 ± 35.6 s. Mean onset of motor blockade with neostigmine group was 197.4 ± 111.6 s and in normal saline group was 219.4 ± 73.2 s. Mean two-segment regression with neostigmine group was 110.6 ± 22.7 s and in normal saline group was 71.5 ± 17.1 min. Duration of analgesia with neostigmine group was 336.3 ± 54.5 min and in normal saline group was 188.8 ± 18.4 min. CONCLUSIONS: Intrathecal neostigmine is associated with significantly prolonged sensory, motor blockade, and effective postoperative analgesia.
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spelling pubmed-60205632018-06-29 Intrathecal Bupivacaine with Neostigmine and Bupivacaine with Normal Saline for Postoperative Analgesia: A Cost-effective Additive Kumari Vasantha, Naga Seshu Madhusudhana, Ravi Anesth Essays Res Original Article CONTEXT: In day-to-day practice, subarachnoid block remains the most common type of anesthesia. Bupivacaine is commonly used local anesthetic of neuraxial blockade, though earlier 5% xylocaine and now ropivacaine and levobupivacaine are also used. Additives such as opioids and α(2) agonists are also used. We are using neostigmine as an additive with bupivacaine to see the duration of postoperative analgesia. AIMS: To compare the efficacy of intrathecal hyperbaric bupivacaine with neostigmine when compared to hyperbaric bupivacaine with normal saline with regard to time of onset and duration of sensory and motor blockade, time to two-segment regression. SETTINGS AND DESIGN: Randomized, double-blinded study. SUBJECTS AND METHODS: One hundred patients admitted for lower abdominal and lower limb surgeries done under spinal anesthesia (SA) during the period of February 2015–August 2016. STATISTICAL ANALYSIS USED: Data were entered into Microsoft excel data sheet and analyzed using SPSS 22 version. Categorical data were represented in the form of frequencies and proportions. Chi-square was used as a test of significance. Continuous data were represented as a mean and standard deviation. Independent t-test was used as a test of significance to identify the mean difference between two groups. RESULTS: Mean onset of sensory blockade with neostigmine group was 174.1 ± 107.1 s and in normal saline group 171 ± 35.6 s. Mean onset of motor blockade with neostigmine group was 197.4 ± 111.6 s and in normal saline group was 219.4 ± 73.2 s. Mean two-segment regression with neostigmine group was 110.6 ± 22.7 s and in normal saline group was 71.5 ± 17.1 min. Duration of analgesia with neostigmine group was 336.3 ± 54.5 min and in normal saline group was 188.8 ± 18.4 min. CONCLUSIONS: Intrathecal neostigmine is associated with significantly prolonged sensory, motor blockade, and effective postoperative analgesia. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC6020563/ /pubmed/29962592 http://dx.doi.org/10.4103/aer.AER_184_17 Text en Copyright: © 2018 Anesthesia: Essays and Researches http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Kumari Vasantha, Naga Seshu
Madhusudhana, Ravi
Intrathecal Bupivacaine with Neostigmine and Bupivacaine with Normal Saline for Postoperative Analgesia: A Cost-effective Additive
title Intrathecal Bupivacaine with Neostigmine and Bupivacaine with Normal Saline for Postoperative Analgesia: A Cost-effective Additive
title_full Intrathecal Bupivacaine with Neostigmine and Bupivacaine with Normal Saline for Postoperative Analgesia: A Cost-effective Additive
title_fullStr Intrathecal Bupivacaine with Neostigmine and Bupivacaine with Normal Saline for Postoperative Analgesia: A Cost-effective Additive
title_full_unstemmed Intrathecal Bupivacaine with Neostigmine and Bupivacaine with Normal Saline for Postoperative Analgesia: A Cost-effective Additive
title_short Intrathecal Bupivacaine with Neostigmine and Bupivacaine with Normal Saline for Postoperative Analgesia: A Cost-effective Additive
title_sort intrathecal bupivacaine with neostigmine and bupivacaine with normal saline for postoperative analgesia: a cost-effective additive
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6020563/
https://www.ncbi.nlm.nih.gov/pubmed/29962592
http://dx.doi.org/10.4103/aer.AER_184_17
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