Comparison of analgesic activity of the addition to neostigmine and fentanyl to bupivacaine in postoperative epidural analgesia
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2006
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Objectives: To compare the analgesic and side effects of bupivacaine in combinations with neostigmine and fentanyl using patient-controlled-epidural analgesia (PCEA) methods in the postoperative period after abdominal hysterectomy. Methods: Seventy-five adult American Society of Anesthesiologists physical status I-II patients, aged 18-65 years were included in the study. The study took place in Celal Bayar University Hospital, Turkey between 2003-2004 years. After preoperative epidural catheterization, the patients were operated under general anesthesia. After surgery, the patients were randomly allocated in a double-blinded manner to receive PCEA and divided into 3 groups: Group B: 0.125% bupivacaine, Group N: 0.125% bupivacaine plus neostigmine 4 μg kg-1 and Group F: 0.125% bupivacaine plus 1 μg kg-1 fentanyl solutions (10 mL loading dose, 5 mL bolus dose, 10 min lockout time, 30 mL in 4 hour limit). During the following 24 hours, hemodynamic parameters, pain score using visual analog scale, total analgesic consumption, additional analgesic requirements, sedation, satisfaction, nausea scores and probable side-effects were evaluated. Results: Total analgesic consumption was 143.7 ± 7.2 mL in Group B, 123.4 ± 6.2 mL in Group N and 106 ± 8.3 mL in Groups F. The mean value in Group F was significantly lower than Group N and Group B (p<0.05), and was lower in Group N than Group B. Visual analog scale scores were lower in Group F than other groups (p<0.05). There were no differences in side effects between all groups. Conclusions: Fentanyl and neostigmine by the PCEA method can be used safely for postoperative analgesia after gynecologic surgery. They increase analgesia quality and satisfaction without an increase in side effects.
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Adolescent , Adult , Aged , Analgesia, Epidural , Analgesics , Anesthetics, Local , Bupivacaine , Cholinesterase Inhibitors , Double-Blind Method , Female , Fentanyl , Humans , Hysterectomy , Middle Aged , Narcotics , Neostigmine , Pain, Postoperative , bupivacaine , diclofenac , fentanyl , neostigmine , nitrous oxide , oxygen , sevoflurane , thiopental , vecuronium , analgesic agent , bupivacaine , cholinesterase inhibitor , fentanyl , local anesthetic agent , narcotic agent , neostigmine , abdominal hysterectomy , adult , aged , analgesic activity , anesthesist , article , bolus injection , clinical trial , controlled clinical trial , controlled study , double blind procedure , drug efficacy , drug safety , epidural anesthesia , general anesthesia , hallucination , hemodynamic parameters , human , hypotension , loading drug dose , major clinical study , nausea , pain assessment , patient controlled analgesia , patient satisfaction , postoperative analgesia , postoperative pain , postoperative period , practice guideline , pruritus , randomized controlled trial , sedation , Turkey (republic) , university hospital , uterus disease , visual analog scale , vomiting , adolescent , female , hysterectomy , middle aged , postoperative pain