Document Detail


Intrathecal bupivacaine with morphine or neostigmine for postoperative analgesia after total knee replacement surgery.
MedLine Citation:
PMID:  11444449     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To compare the postoperative analgesic efficacy and safety of intrathecal (IT) neostigmine and IT morphine in patients undergoing total knee replacement under spinal anesthesia. METHODS: Sixty patients scheduled for elective total knee replacement under spinal anesthesia were randomly divided into three equal groups which received IT 0.5% hyperbaric bupivacaine 15 mg with either normal saline 0.5 mL, neostigmine 50 microg, or morphine 300 microg. The maximal level of sensory block, duration of analgesia, time to use of rescue analgesics, the overall 24-hr and four-hour interval visual analogue scale (VAS) pain score, and the incidence of adverse effects were recorded for 24 hr after administration. RESULTS: There was no significant difference in maximal level of sensory block among the three groups. The morphine group had a later onset of postsurgical pain and longer time to first rescue analgesics than the neostigmine group (P <0.05). Overall 24-hr VAS pain scores were significantly higher in the saline group vs the morphine and neostigmine groups (P <0.05). Motor block lasted significantly longer in the neostigmine group than in the morphine and saline groups (P <0.05). The incidence of adverse effects was similar in the neostigmine and morphine groups except for pruritus (70%) occurring more frequently in the morphine group than in the neostigmine and saline groups (0%; P <0.05). Overall satisfaction rates were better in the neostigmine group than in the morphine and saline groups (P <0.05). CONCLUSIONS: IT neostigmine 50 microg produced postoperative analgesia lasting about seven hours with fewer side effects and better satisfaction ratings than IT morphine 300 microg.
Authors:
P H Tan; Y Y Chia; Y Lo; K Liu; L C Yang; T H Lee
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  48     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2001-07-10     Completed Date:  2001-12-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  551-6     Citation Subset:  IM    
Affiliation:
Department of Anesthesia, Chang-Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China. tanph@gcn.net.tw
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MeSH Terms
Descriptor/Qualifier:
Aged
Analgesics, Opioid / administration & dosage,  therapeutic use*
Anesthetics, Local / administration & dosage,  therapeutic use*
Arthroplasty, Replacement, Knee*
Bupivacaine / administration & dosage,  therapeutic use*
Cross-Over Studies
Double-Blind Method
Female
Humans
Injections, Spinal
Male
Middle Aged
Morphine / administration & dosage,  therapeutic use*
Neostigmine / administration & dosage,  therapeutic use*
Pain, Postoperative / drug therapy*
Parasympathomimetics / administration & dosage,  therapeutic use*
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Anesthetics, Local; 0/Parasympathomimetics; 2180-92-9/Bupivacaine; 57-27-2/Morphine; 59-99-4/Neostigmine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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