African journal of medicine and medical sciences
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Randomized Controlled Trial
Analgesic effect of intrathecal neostigmine combined with bupivacaine and fentanyl.
The spinal route of analgesia has consolidated its place as a major modality in the management of both acute and chronic pain. The search for ideal additives to local anaesthetic agents to prolong the analgesic effects poses a challenge to the anaesthetists. Neostigmine, an anticholinesterase, presents a novel approach to providing analgesia. Neostigmine, when given intrathecally, inhibits breakdown of an endogenous spinal neurotransmitter, acetylcholine, thereby inducing analgesia. We aimed to determine the analgesic and adverse effects of intrathecal neostigmine combined with hyperbaric bupivacaine and fentanyl. ⋯ This study showed that spinal neostigmine 25 microg added to hyperbaric bupivacaine and fentanyl provided a significantly longer surgical analgesia and insignificant adverse effects in male adults who had lower abdominal surgery under spinal anaesthesia.