PT  - JOURNAL ARTICLE
AU  - Selcen Tekin
AU  - Ismet Topcu
AU  - Neriman Z. Ekici
AU  - Husnu Caglar
AU  - Tuna Erincler
TI  - Comparison of analgesic activity of the addition to neostigmine and fentanyl to bupivacaine in postoperative epidural analgesia
DP  - 2006 Aug 01
TA  - Saudi Medical Journal
PG  - 1199--1203
VI  - 27
IP  - 8
4099  - http://smj.org.sa/content/27/8/1199.short
4100  - http://smj.org.sa/content/27/8/1199.full
SO  - Saudi Med J2006 Aug 01; 27
AB  - OBJECTIVE: 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 ug kg-1 and Group F: 0.125% bupivacaine plus 1 ug 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.CONCLUSION: 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.