Dose-Response Study of Intrathecal Morphine Versus Intrathecal Neostigmine, Their Combination, or Placebo for Postoperative Analgesia in Patients Undergoing Anterior and Posterior Vaginoplasty

Lauretti, Gabriela Rocha; Reis, Marlene Paulino dos; Prado, Wiliam A.; Klamt, Jyrson Guilherme

doi:10.1213/00000539-199606000-00014

Cited by 35 publications

(73 citation statements)

References 18 publications

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“…8 Acetylcholine being released from preganglionic sympathetic ganglia has been shown to have action at other spinal sites like inhibition of motor neuron activity and excitation of sympathetic outflow. 2 Spinal neostigmine is advantageous over other currently used spinal drugs as it causes no hypotension (excitation of sympathetic outflow), no sedation, no respiratory depression or neurological dysfunction. 2,3 In our study the mean lowest heart rate during spinal anaesthesia in all the three groups were comparable and statistically insignificant.…”

Section: Discussionmentioning

confidence: 99%

“…2 Spinal neostigmine is advantageous over other currently used spinal drugs as it causes no hypotension (excitation of sympathetic outflow), no sedation, no respiratory depression or neurological dysfunction. 2,3 In our study the mean lowest heart rate during spinal anaesthesia in all the three groups were comparable and statistically insignificant. On comparing the haemodynamic parameters, we found that the mean systolic blood pressure before spinal anaesthesia and the lowest mean systolic blood pressure and lowest mean diastolic blood pressure did not differ significantly between the three groups.…”

Section: Discussionmentioning

confidence: 99%

“…8,16 Auto radiography have demonstrated muscarnic binding in the substantia gelatinosa and to a lesser extent in lamine III and V of gray matter of the spinal cord. 2 The effects of spinal neostigmine and edrophonium emphasize the relevance of the release of endogenous acetylcholine from spinal systems. 17 This reflects that anti nociception is produced by inhibition of transmitter (ACh) metabolism.…”

Section: Discussionmentioning

confidence: 99%

“…2 Spinal neostigmine is advantageous over other currently used spinal drugs as it causes no hypotension (excitation of sympathetic outflow), no sedation, no respiratory depression or neurological dysfunction. 2,3 Bupivacaine was the first local anaesthetic that produced adequate pain relief, without a major effect on motor fibres. 4 Neostigmine has been shown to counteract haemodynamic effects of clonidine and bupivacaine.…”

mentioning

confidence: 99%

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Evaluation of intrathecal neostigmine in different doses added to bupivacaine for postoperative analgesia

Bhat¹,

Ommid

Gupta

et al. 2011

Sri Lankan J Anaesthesiol

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…2 Spinal neostigmine is advantageous over other currently used spinal drugs as it causes no hypotension (excitation of sympathetic outflow), no sedation, no respiratory depression or neurological dysfunction. 2,3 Bupivacaine was the first local anaesthetic that produced adequate pain relief, without a major effect on motor fibres. 4 Neostigmine has been shown to counteract haemodynamic effects of clonidine and bupivacaine.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of intrathecal neostigmine in different doses added to bupivacaine for postoperative analgesia

Bhat¹,

Ommid

Gupta

et al. 2011

Sri Lankan J Anaesthesiol

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show abstract

“…25,51,64,75,88,102 Most of these studies used pulse oximetry, though Lauretti et al ambiguously measured "oxygen saturations". 88 SpO 2 values ranging from "# 85%" 25 to "# 94%" 51 were used in the definitions. Two other studies included presence of cyanosis, RR and either oxyhemoglobin saturation from SpO 2 37 or ABG analysis 38 in their definitions.…”

Section: Discussionmentioning

confidence: 99%

Définitions de la “dépression respiratoire” de l’analgésie postopératoire réalisée avec de la morphine intrathécale : une revue documentaire

Goldstein

VanDenKerkhof

2003

Can J Anesth/J Can Anesth

108

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P Pu ur rp po os se e: : To review the postoperative intrathecal morphine (ITM) analgesia literature for their definitions of "respiratory depression" (RD).S So ou ur rc ce e: : Medline (1966 -June Week 5 2001) and reference lists were searched for original studies involving bolus-dose ITM for postoperative analgesia, which used "respiratory depression" or similar terms. P Pr ri in nc ci ip pa al l f fi in nd di in ng gs s: : The search identified 209 studies. These were included if ITM use was appropriate (bolus dose, postoperative analgesia) and the term "respiratory depression" was used, which left 96 studies remaining. Forty-four (46%) did not define "RD" despite using this term. A further 24 (25%) defined RD with respiratory rate (RR) alone. Only 28 (29%) defined RD with more than RR alone. There was no statistically significant association between the presence of a definition for RD with study design, study size or publication period. Also, no significant association existed between rigorousness of RD definitions and the above factors.C Co on nc cl lu us si io on n: : The term "respiratory depression" has no clear definition from a review of the literature on ITM use for postoperative analgesia. While defining RD with bradypnea is superior to having no definition, this is still inadequate. In future research, the consistent use of terms with specific meanings will facilitate understanding the true incidence of ITM's respiratory effects. If "respiratory depression" is used, then an explicit definition of its meaning should be provided. Future research must also address what is clinically significant respiratory impairment from intrathecal opioids, and how to optimally monitor for this. Further delineating their risks vs benefits will allow for more optimal dosing. Objectif : Passer en revue les documents sur l'analgésie postopéra-toire, réalisée avec la morphine intrathécale (MIT), quant à leurs défi-nitions de la "dépression respiratoire" (DR). Source : La base Medline (1966 -Semaine 5, juin 2001) et les listes de lectures de référence ont été fouillées à la recherche d'études originales sur des bolus de MIT administrés comme analgésie postopéra-toire, et dans lesquelles on retrouve le terme "dépression respiratoire" ou des termes similaires. Constatations principales : La recherche nous a fourni 209 études. Les études (96) comportant un usage approprié de la MIT (dose en bolus, analgésie postopératoire) et l'utilisation du terme

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Antinociceptive profile of the natural cholinesterase inhibitor huperzine A

Galeotti

Ghelardini

Mannelli

et al. 2001

Drug Development Research

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The antinociceptive effect of huperzine A, a novel cholinesterase inhibitor, was investigated in the mouse hot-plate and abdominal constriction tests. Huperzine A induced a dose-dependent antinociception (70-110 µg kg -1 i.p.) which was prevented by scopolamine (0.1 mg kg -1 i.p.) and S-(-)-ET 126 (0.01 µg per mouse i.c.v.), but not by naloxone (1 mg kg -1 i.p.), mecamylamine (2 mg kg -1 i.p.), α-methyl-p-tyrosine (100 mg kg -1 i.p.), or CGP 35348 (100 mg kg -1 i.p.). A dose-dependent inhibition of the antinociception induced by huperzine A (110 µg kg -1 i.p.) was observed after inactivation of the M 1 gene by an antisense oligodeoxyribonucleotide (aODN). This effect was detected 24 h after the last intracerebroventricular injection of aODN. Time-course experiments revealed that, after the end of the aODN treatment, sensitivity to analgesic drugs progressively appeared, reaching the normal range at 96 h. Huperzine A, at the maximal effective doses, did not produce any alteration of mice motor coordination, as revealed by rota-rod experiments. These results indicate that huperzine A is endowed by muscarinic antinociceptive properties mediated by the activation of central M 1 muscarinic receptor subtype. Drug Dev. Res. 54:19-26, 2001.

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Dose-Response Study of Intrathecal Morphine Versus Intrathecal Neostigmine, Their Combination, or Placebo for Postoperative Analgesia in Patients Undergoing Anterior and Posterior Vaginoplasty

Cited by 35 publications

References 18 publications

Evaluation of intrathecal neostigmine in different doses added to bupivacaine for postoperative analgesia

Evaluation of intrathecal neostigmine in different doses added to bupivacaine for postoperative analgesia

Définitions de la “dépression respiratoire” de l’analgésie postopératoire réalisée avec de la morphine intrathécale : une revue documentaire

Antinociceptive profile of the natural cholinesterase inhibitor huperzine A

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