Integrity of Intestinal Anastomoses Following Muscle Relaxant Reversal With Neostigmine

En, Brown; Mj, Daughety; Wc, Petty

doi:10.1213/00000539-197301000-00035

Cited by 4 publications

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“…Neostigmine is frequently used to reverse the action of muscle relaxants after surgery and it has sometimes been used to treat paralytic post‐operative ileus. However, since 1968, its use has been controversial after bowel anastomosis [1–11]. Many authors have suggested that neostigmine increases the rate of anastomotic disruption because of its prokinetic effect [1], and they have advised caution in its administration [1,7,8,10,11].…”

Section: Introductionmentioning

confidence: 99%

“…The use of neostigmine to reverse the action of the muscle relaxant as a final anaesthetic manoeuvre in abdominal surgery has been widely discussed, particularly when a bowel anastomosis is per‐ formed [1–11]. It appears clear that the prokinetic effect of neostigmine occurs in both the small and large bowel; however, different studies have shown contradictory results about the intensity of this effect on each intestinal segment [1,3,11].…”

Section: Introductionmentioning

confidence: 99%

“…They evaluated anastomotic leakage by accurate clinical criteria. Many other authors have discussed the post‐operative use of neostigmine in the context of experimental studies or in reviews of anaesthesia [2,3,5–11].…”

Section: Introductionmentioning

confidence: 99%

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

García-Rivas

García‐Olmo

1998

Eur J Anaesthesiol

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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.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

García-Rivas

García‐Olmo

1998

Eur J Anaesthesiol

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Effets de la décurarisation post-opératoire par la néostigmine sur les anastomoses digestives

Morisot

Loygue

Guilmet

1975

Canad. Anaesth. Soc. J.

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A prospective study was undertaken to assess the influence of neostigmine, a reversal agent for curarimimetic myorelaxants, on the incidence of postoperative disruption of anastomotic sites. Over a period of one year, 400 patients had surgery, including anastomosis, on the digestive tract for a variety of surgical conditions (Table II). At the end of anaesthesia, 200 patients received doses of atropine and neostigmine, usually 1 mg and 2.5 mg of each, as indicated on clinical basis and neuromuscular stimulation. The other patients did not recieve these drugs and were ventilated till the myorelaxation vanished spontaneously. During the postoperative period of incidence of anastomotic breakdown was assessed by the surgeon, unaware of the use or the omission of neostigmine in his patients. Anastomotic leakage was classified in four groups, namely: proved, absent, likely and unlikely. In this series and according to these clinical criteria, both groups had an incidence of anastomotic breakdown which was not significantly different (Table III). Neostigmine as used in this work does not seem to compromise the normal healing of anastomotic sites on the digestive tract.

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Neostigmine After Bowel Surgery

Brodsky

1974

The Lancet

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Integrity of Intestinal Anastomoses Following Muscle Relaxant Reversal With Neostigmine

Cited by 4 publications

References 0 publications

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

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

Effets de la décurarisation post-opératoire par la néostigmine sur les anastomoses digestives

Neostigmine After Bowel Surgery

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