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.

Clinical implications of sugammadex

“…There is also a theoretical possibility that the use of neostigmine will compromise colonic anastomoses [34, 35]. However, in rats there did not seem to be any deleterious effect of neostigmine on new colonic anastomoses [36]. These considerations become non‐issues with the use of sugammadex.…”

Adversities related to neuromuscular blockade and reversal

“…78 Não há qualquer evidência, até o momento, de que neostigmina comprometa anastomoses intestinais. 79…”