Analgesia following transurethral resection of prostate using preoperative subarachnoid bupivacaine with neostigmine

Abstract EN

Objective : The present work was designed to assess the postoperative analgesic efficacy of preoperative subarachnoid bupivacaine block (S.

A.

B.

B) with small added dose of neostigmine in patients undergoing transurethral resection of prostate (T.

U.

R.

P).

Patients and methods : This study included 85 male patients, ASA Π or Ш, scheduled for T.

U.

R.

P.

under S.

A.

B.

B.

According to the adjuvant test solution added to subarachnoid hyperbaric 0.5 % bupivacaine 2.8 ml (14mg), patients were randomly allocated into 2 groups : group І (n = 41, control) where patients received 1 ml saline 0.9 %, while patients in Group Π (n = 44) received 50 μg of neostigmine.

The level of sensory block, motor block ; duration to absolute analgesia ; first time to use postoperative analgesia ; the overall 24 hours and 2 hours interval visual analogue scale (V.

A.

S.).

Pain score were recorded for 24 hours post-S.

A.

B.

B.

Results : Neostigmine 50μg added to S.

A.

B.

B.

significantly increased the duration of motor block.

The neostigmine group had a delayed onset of post operative pain and a longer duration to need for first postoperative analgesic than the Control group.

Overall 24-h V.

A.

S.

pain scores were significantly higher in the control group versus the neostigmine group.

There was no significant difference in maximal level of sensory block among the two groups.

Conclusion : S.

A.

B.

B.

is appropriate to use in T.

U.

R.

P.

Neostigmine added to S.

A.

B.

B.

produced absolute postoperative analgesia lasting 8 hours with improvement in the quality of S.

A.

B.

B.