Does neostigmine have a deleterious effect on the resistance of colonic anastomoses?

Abstract

0.01; obstruction, P=0.047). Also, consumption of water by group 2 was greater than that by group 1 The aim of the present study was to evaluate the (P=0.049). No statistically significant differences were effects of neostigmine as a final anaesthetic manfound between the diameters of the colon (pre-and oeuvre on colonic anastomoses. A colonic anapost-anastomosis), or with respect to general adstomosis was constructed in 40 Sprague-Dawley rats.hesions and adhesions to the anastomotic line. No The animals were divided into two groups: (1) rats significant differences were found between anreceiving intravenous saline solution (placebo); and (2) astomotic resistance (determined in terms of bursting rats receiving an intravenous injection of neostigmine.pressure and bursting wall tension) in the two groups. The size of the caecum, and the diameters of the pre-The inclusion of neostigmine in an anaesthetic proanastomotic and post-anastomotic colon were meastocol under experimental setting did not reduce the ured during the operation and 4 days after surgery, resistance of colonic anastomoses and did not comwhen all the animals were sacrificed. At this time, the promise normal healing. Moreover, obstruction presence of adhesions was also investigated. Each caused by peristaltic weakness might be prevented by segment containing an anastomosis was removed, the expulsion of stool that is induced by the strong and the bursting pressure and bursting wall tension contraction of the colonic smooth muscle. were determined. Loss of caecum diameter was significantly greater in group 2 than in group 1 (P= Keywords: neostigmine, colonic anastomosis, anastomosis healing, anastomosis resistance, intestinal 0.03). Dilatation and obstruction of the colon were significantly more frequent in group 1 (dilatation, P= obstruction.

Coercivity extrema in melt-spun CuCo ribbons: Effects of the magnetic moment distribution

“…The same equation is valid for all the tested values of the magnetic moment between 5000 and 65 000 B . The exponent of 0.76 for the decrease in the coercivity with the temperature is between the values of 3/4 and 0.77 calculated, respectively, by Garcia-Otero et al 19 and Pfeiffer. 20 Starting from the result by Pfeiffer, Chen et al 21 obtained a much larger exponent of 1.155 when the anisotropy field is due to the uniaxial surface anisotropy.…”

“…The Monte Carlo simulations accurately reproduce the dependence of the coercivity on the temperature as predicted in the Néel relaxation model for a system of granules with the same magnetic moment. 19,20 For a dispersed system, however, the thermal behavior of the coercivity is very sensitive to the actual distribution of magnetic moments. In general, H c (T) is implicitly defined by the balance between the negative magnetization of superparamagnetic granules and the remaining magnetization of blocked granules after saturation in the positive field direction as So a coherent interpretation of the experimental results can be obtained in terms of the distribution of magnetic moments.…”

The effect of on-demand vs deep neuromuscular relaxation on rating of surgical and anaesthesiologic conditions in patients undergoing thoracolaparoscopic esophagectomy (DEPTH trial): study protocol for a randomized controlled trial

“…When employing deep NMB, one has the option to use sugammadex, which is costly, or have the patient on mechanical ventilation post-operatively, which may increase the incidence of pneumonia following surgery [ 1 ]. Reversal with (high-dose) neostigmine is usually not favored following these procedures in fear of the cholinergic effects on the newly formed anastomosis, although recent evidence for the adverse effects on anastomotic patency is scarce and the existing data are conflicting [ 6 – 8 ].…”

“…The use of neostigmine not only is insufficient for reversing deep NMB but also is contraindicated for moderate NMB because of its cholinergic effects on smooth muscle that may increase the risk of anastomotic dehiscence, although the evidence is conflicting [ 6 – 8 ]. In addition, neostigmine may be associated with increased risk of respiratory complications post-operatively because of high incidence of residual neuromuscular relaxation [ 9 ].…”