ANALGESIC EFFICACY OF LOW DOSE INTRATHECAL NEOSTIGMINE IN COMBINATION WITH FENTANYL AND BUPIVACAINE FOR LOWER ABDOMINAL AND LOWER LIMB SURGERY-A PROSPECTIVE RANDOMIZED DOUBLE BLIND STUDY

Abstract

BACKGROUND: Intrathecal (IT) neostigmine has been used as an adjunct to spinal anesthesia. The purpose of this study was to determine whether a combination of low-dose neostigmine IT would enhance analgesia of a xed dose of fentanyl IT, in patients undergoing lower abdominal and lower limb surgeries To e AIM: valuate the analgesic efcacy of low dose intrathecal Neostigmine in combination with Fentanyl and Bupivacaine for lower abdominal and lower limb surgeries. OBJECTIVES: 1. To compare the onset of sensory and motor blockade. 2. To evaluate the piont of maximum sensory blockade. 3. To assess the VAS pain score,rst rescue analgesia time and adverse effects. METHODOLOGY: After obtaining approval from institutional ethics committe and informed consent,50 patients with ASA class I and II patients posted for elective lower abdominal and lower limb surgeries were selected and randomly divided into two gruops. GROUP A: Intrathecal Bupivacaine 12.5mg(2.5ml)+Fentany 20mcg (0.4ml)+ Normal saline (0.1ml) (Total 3ml). GROUP B: Intrathecal Bupivacaine 12.5mg(2.5ml)+Fentany 20mcg (0.4ml)+ Neostigmine 1mcg (0.1ml) (Total 3ml). Statistical analysis wa RESULTS: s done with paired t-test,student t test and chi square test .The p-valve p<0.005 was considered statistically signicant.Both the groups showed statistically signicant differance in terms of sensory blockade and recovery of sensory blockade.Group B showed the early onset of sensory blockade and prolonged recovery time. CONCLUSION : Intrathecal neostigmine precipitated the onset of motor and sensory blockade and prolongs the block signicantly when used with Bupivacaine and Fentanyl in spinal anaesthesia in a low dose.