Analgesic effect of epidural neostigmine after abdominal hysterectomy.

Abstract Study Objective: To evaluate the effects of epidurally administered neostigmine on pain after abdominal hysterectomy. Design: Prospective, randomized, double-blind study. Setting: Teaching hospital. Patients: 45 ASA physical status I adult patients scheduled for abdominal hysterectomy. Interventions: All patients received identical general and epidural anesthesia. At the end of the surgery, they received epidural bupivacaine (10 mg) with either saline (control group, n = 15), 5 μg/kg (5-μg group, n = 15), or 10 μg/kg neostigmine (10-μg group, n = 15). Postoperatively, 50 mg diclofenac suppository was given for pain relief on patient demand. Measurements and Main Result: The time to first diclofenac administration and the number of times diclofenac was required during the first 24 postoperative hours were recorded. Pain was assessed using a 10-cm visual analog pain scale (VAS) at rest at the first diclofenac request, and at 15 and 24 hours after surgery. The time to first diclofenac administration was significantly longer ( p Conclusions: Epidural neostigmine of 10 μ g/kg in bupivacaine provides a longer duration of analgesia than does bupivacaine alone or with 5 μg/kg of neostigmine after abdominal hysterectomy.