Prospective randomized double blind study to evaluate the analgesic efficacy of low dose of intrathecal neostigmine in combination with fentanyl and bupivacaine for lower abdominal and lower limb surgery

Abstract

More than 80% of patients undergoing surgical procedures under spinal anesthesia experience acute post-operative pain. The aim of the study was to compare the analgesic efficacy and side effects of addition of neostigmine to fentanyl and bupivacaine. 50 patients scheduled for elective lower abdominal and lower limb surgeries likely to finish within 3 hours, were put into two groups. 25 patients in each group aged between 18 to 60 years of either sex belonging to the ASA grade I & II. Group A was given Intrathecal Bupivacaine 12.5 mg (2.5 ml) + Fentanyl 20 µg (0.4 ml)+0.1 ml Normal Saline (Total 3 ml) and Group B was given Intrathecal Bupivacaine 12.5 mg (2.5 ml) + Fentanyl 20 µg (0.4 ml) + Neostigmine 1µg (0.1 ml) (Total 3 ml). Subjects were monitored for occurrence of any adverse events after spinal injection. We observed statistically significant difference between the two groups in the onset of sensory blockade and recovery of sensory blockade. Onset of sensory blockade was earlier in Group B and recovery time was prolonged in Group B. No difference was seen in maximal sensory blockade.