Postoperative analgesic effect of intrathecal neostigmine and its influence on spinal anaesthesia

Klamt, Jyrson Guilherme; Slullitel, Alexandre; Garcia, L; Prado, Wiliam A.

doi:10.1111/j.1365-2222.1997.115-az0111.x

Cited by 51 publications

(70 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thirteen trials (16 comparisons) tested morphine 0.05 to 2 mg added to bupivacaine compared with bupivacaine alone and reported on the duration of postoperative analgesia [3,4,21,30,34,37,38,43,46,61,63,69,75] (Fig. 2).…”

Section: Duration Of Postoperative Analgesiamentioning

confidence: 99%

“…Seventeen trials (21 comparisons) tested morphine 0.05 to 1 mg added to bupivacaine and reported on the incidence of postoperative pruritus [4,21,30,34,[37][38][39][41][42][43]46,56,61,69,74,75,79] (Table 2; Supplemental Data 6). The average incidence of pruritus with bupivacaine alone was 4.4%.…”

Section: Pruritusmentioning

confidence: 99%

“…Six trials (9 comparisons) tested morphine 0.05 to 0.5 mg added to bupivacaine and reported the number of patients requiring an opioid for rescue analgesia postoperatively [34,38,39,42,46,61] (Supplemental Data 4). The proportion of controls requiring opioids ranged from 0% to 100% (median, 73%).…”

Section: Number Of Patients Requiring Opioids Postoperativelymentioning

confidence: 99%

“…Fourteen trials (19 comparisons) tested morphine 0.05 to 0.5 mg added to bupivacaine and reported on presence or absence of postoperative respiratory depression [4,6,34,35,37,38,[41][42][43]46,56,61,75,79]. Respiratory depression was defined as respiratory rates <8, <9, <10, or <12 min À1 , or as PaCO 2 >6 kPa or different ranges of SpO 2 , or as the need for naloxone treatment.…”

Section: Respiratory Depressionmentioning

confidence: 99%

See 3 more Smart Citations

Opioids added to local anesthetics for single-shot intrathecal anesthesia in patients undergoing minor surgery: A meta-analysis of randomized trials

Pöpping

Elia

Marret

et al. 2012

Pain

View full text Add to dashboard Cite

a b s t r a c tOpioids are widely used as additives to local anesthetics for intrathecal anesthesia. Benefit and risk remain unclear. We systematically searched databases and bibliographies to February 2011 for full reports of randomized comparisons of any opioid added to any intrathecal local anesthetic with the local anesthetic alone in adults undergoing surgery (except cesarean section) and receiving single-shot intrathecal anesthesia without general anesthesia. We included 65 trials (3338 patients, 1932 of whom received opioids) published between 1983 and 2010. Morphine (0.05-2 mg) and fentanyl (10-50 lg) added to bupivacaine were the most frequently tested. Duration of postoperative analgesia was prolonged with morphine (weighted mean difference 503 min; 95% confidence interval [CI] 315 to 641) and fentanyl (weighted mean difference 114 min; 95% CI 60 to 168). Morphine decreased the number of patients needing opioid analgesia after surgery and decreased pain intensity to the 12th postoperative hour. Morphine increased the risk of nausea (number needed to harm [NNH] 9.9), vomiting (NNH 10), urinary retention (NNH 6.5), and pruritus (NNH 4.4). Fentanyl increased the risk of pruritus (NNH 3.3). With morphine 0.05 to 0.5 mg, the NNH for respiratory depression varied between 38 and 59 depending on the definition of respiratory depression chosen. With fentanyl 10 to 40 lg, the risk of respiratory depression was not significantly increased. For none of these effects, beneficial or harmful, was there evidence of dose-responsiveness. Consequently, minimal effective doses of intrathecal morphine and fentanyl should be sought. For intrathecal buprenorphine, diamorphine, hydromorphone, meperidine, methadone, pentazocine, sufentanil, and tramadol, there were not enough data to allow for meaningful conclusions.Ó

show abstract

Section: Duration Of Postoperative Analgesiamentioning

confidence: 99%

Section: Pruritusmentioning

confidence: 99%

Section: Number Of Patients Requiring Opioids Postoperativelymentioning

confidence: 99%

Section: Respiratory Depressionmentioning

confidence: 99%

See 2 more Smart Citations

Opioids added to local anesthetics for single-shot intrathecal anesthesia in patients undergoing minor surgery: A meta-analysis of randomized trials

Pöpping

Elia

Marret

et al. 2012

Pain

View full text Add to dashboard Cite

show abstract

“…Furthermore, neostigmine has been recently shown to produce long-lasting postoperative analgesia [Klamt et al, 1997] and to enhance opioid analgesia in human patients [Lauretti et al, 1996;Klamt et al, 1999;Nelson et al, 1999].…”

Section: Introductionmentioning

confidence: 99%

Antinociceptive profile of the natural cholinesterase inhibitor huperzine A

Galeotti

Ghelardini

Mannelli

et al. 2001

Drug Development Research

View full text Add to dashboard Cite

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.

show abstract

Drugs for preventing postoperative nausea and vomiting

Carlisle

Stevenson²

2006

Cochrane Database of Systematic Reviews

227

133

View full text Add to dashboard Cite

Either nausea or vomiting is reported to affect, at most, 80 out of 100 people after surgery. If all 100 of these people are given one of the listed drugs, about 28 would benefit and 72 would not. Nausea and vomiting are usually less common and, therefore, drugs are less useful. For 100 people, of whom 30 would vomit or feel sick after surgery if given placebo, 10 people would benefit from a drug and 90 would not. Between one to five patients out of every 100 people may experience a mild side effect, such as sedation or headache, when given an antiemetic drug. Collaborative research should focus on determining whether antiemetic drugs cause more severe, probably rare, side effects. Further comparison of the antiemetic effect of one drug versus another is not a research priority.

show abstract

Postoperative analgesic effect of intrathecal neostigmine and its influence on spinal anaesthesia

Cited by 51 publications

References 14 publications

Opioids added to local anesthetics for single-shot intrathecal anesthesia in patients undergoing minor surgery: A meta-analysis of randomized trials

Opioids added to local anesthetics for single-shot intrathecal anesthesia in patients undergoing minor surgery: A meta-analysis of randomized trials

Antinociceptive profile of the natural cholinesterase inhibitor huperzine A

Drugs for preventing postoperative nausea and vomiting

Contact Info

Product

Resources

About