JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS
AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
A&A International Anesthesia Research Society
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (13)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Abdulatif, M.
Right arrow Articles by El-Sanabary, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Abdulatif, M.
Right arrow Articles by El-Sanabary, M.
Related Collections
Right arrow Pediatrics
Right arrow Pain
Right arrow Pharmacology

Anesth Analg 2002;95:1215-1218
© 2002 International Anesthesia Research Society

PEDIATRIC ANESTHESIA

Caudal Neostigmine, Bupivacaine, and Their Combination for Postoperative Pain Management After Hypospadias Surgery in Children

Mohamed Abdulatif, MB BCH, MSc, MD, and Mohga El-Sanabary, MB BCH, MSc, MD

Department of Anesthesiology, Cairo University, Egypt

Address correspondence and reprint requests to Mohamed Abdulatif, MD, PO Box 147, Panorama October 11811, Nasr City, Cairo, Egypt. Address e-mail to abdulatif{at}hotmail.com

In a randomized, double-blinded study, we examined the analgesic efficacy of caudal neostigmine, bupivacaine, or a mixture of both drugs in 60 children. After the induction of general anesthesia, children were allocated randomly into three groups (n = 20) to receive a caudal injection of either 0.25% bupivacaine 1 mL/kg, with or without neostigmine 2 µg/kg, or neostigmine 2 µg/kg in normal saline 1 mL/kg. Intraoperatively, children receiving caudal bupivacaine or a bupivacaine/neostigmine mixture maintained hemodynamic stability, required less inhaled anesthetics, and had a shorter recovery time compared with the caudal neostigmine alone. Postoperatively, the caudal bupivacaine/neostigmine mixture resulted in superior analgesia compared with the other two groups. Recovery to first rescue analgesic times were (mean ± SD) 22.8 ± 2.9 h, 8.1 ± 5.9 h, and 5.2 ± 2.1 h in the bupivacaine/neostigmine, bupivacaine, and neostigmine groups, respectively (P < 0.001). In addition, the bupivacaine and neostigmine groups received more doses of paracetamol than the bupivacaine/neostigmine group to maintain adequate analgesia in the first 24 postoperative h. Postoperative vomiting occurred in 25%, 10%, and 30% in the caudal bupivacaine/neostigmine, bupivacaine, and neostigmine groups, respectively (P < 0.01). We conclude that caudal neostigmine 2 µg/kg provides postoperative analgesia comparable to caudal bupivacaine in children undergoing hypospadias repair surgery.

IMPLICATIONS: Caudal neostigmine 2 µg/kg provides postoperative analgesia comparable to caudal bupivacaine in children undergoing hypospadias repair surgery. Co-administration of the two drugs is associated with extended postoperative analgesia and reduced need for supplementary analgesics.




This article has been cited by other articles:


Home page
 Br J AnaesthHome page
N. Almenrader, M. Passariello, R. Mahajan, Y.K. Batra, S. Kumar, and P.A. Lonnqvist
Adjuncts to caudal blockade in children.
Br. J. Anaesth., March 1, 2006; 96(3): 401 - 402.
[Full Text] [PDF]

Home page
 Anesth. Analg.Home page
P. F. White
The Changing Role of Non-Opioid Analgesic Techniques in the Management of Postoperative Pain
Anesth. Analg., November 1, 2005; 101(5S_Suppl): S5 - 22.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
P. A. Lonnqvist
Adjuncts to caudal block in children--Quo vadis?
Br. J. Anaesth., October 1, 2005; 95(4): 431 - 433.
[Full Text] [PDF]

Home page
 Br J AnaesthHome page
T. G. Hansen, S. W. Henneberg, S. Walther-Larsen, J. Lund, and M. Hansen
Caudal bupivacaine supplemented with caudal or intravenous clonidine in children undergoing hypospadias repair: a double-blind study
Br. J. Anaesth., February 1, 2004; 92(2): 223 - 227.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
R. Mahajan, D. A. H. de Beer, and M. L. Thomas
Caudal neostigmine in children
Br. J. Anaesth., November 1, 2003; 91(5): 761 - 762.
[Full Text] [PDF]


Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2002 by the International Anesthesia Research Society.