Original Articles
The effect of addition of neostigmine on dose requirement of ropivacaine 0.1% and on duration of labour in labouring patients receiving lumbar epidural analgesia | |
Dr.Archana Dande, Dr.Anjana K, Dr.Balasubramanya H,Dr. Bala Bhaskar S | |
Neostigmine (acetyl cholinesterase inhibitor) is a parasympathomimetic agent that has been investigated for use as an adjunct analgesic agent in the perioperative and peripartum period. Intrathecal injection of neostigmine increases extracellular acetylcholine levels in spinal cord leading to increased stimulation of spinal muscarinic and possibly nicotinic receptors to produce analgesia. The study was conducted in 50 Primiparous patients in active phase of labour in the labour ward of Department of Obstetrics and Gynecology. Patients were randomized into two groups using computer generated random numbers:Group A:Received 0.1% Ropivacaine with fentanyl2µg/ml in 10 ml total volume.Group B:Received 0.1% Ropivacaine with fentanyl 2µg/ml and neostigmine 500µg in 10 ml total volume.As far as number of supplements are concerned, in group A 44% and group B 88% patients needed 1 supplement at 2nd hour, where as 56% patients in group A and 12% patients in group B needed 2 supplements at 2nd hour, which was statistically significant (p value 0.002). 80% of the patients in group A and 96% patientsin group B did not require any supplements at 1st hour, whereas 20% patients in group A and 4% patients in group B required 1 supplemental dose at 1st hour, which was statistically insignificant (p value 0.189).With regard to number of supplements at 3rd hour, in group A 60% patients and group B 76% patients did not require any supplements, while 40% patients in group |
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