Korean J Anesthesiol.  2004 Nov;47(5):649-654. 10.4097/kjae.2004.47.5.649.

The Effects of Neostigmine added to Ropivacaine for Intravenous Regional Anesthesia

• Kang KS
• Jung SH
• Ahn KR
• Kim CS
• Kim JE
• Yoo SH
• Kwon JH

• KMID: 2236665
• DOI: http://doi.org/10.4097/kjae.2004.47.5.649

Abstract

BACKGROUND: Neostigmine has been added to local anesthetic regimen for epidural or intrathecal block, and this resulted in prolonged and improved analgesia, but evidence of its benefit in intravenous regional anesthesia (IVRA) is controversial. The purpose of this study was to evaluate the effects of neostigmine added to ropivacaine for IVRA.
METHODS
Forty patients undergoing hand or forearm surgery were randomly assigned to two groups to receive IVRA: Group I received 40 ml of 0.2% ropivacaine plus 1 ml of normal saline, and group II received 40 ml of 0.2% ropivacaine plus 500microgram (1 ml) of neostigmine. Sensory block onset time, postoperative visual analogue scale (VAS) scores, recovery time from motor block after deflation, mean arterial pressure (MAP), heart rate (HR), and pulse oximeter saturation (SpO2) values were measured. The incidence of side effects was recorded.
RESULTS
Group II had a shorter sensory block onset time, a prolonged motor block recovery time, and lower postoperative VAS scores. No significant difference was found between the two the groups in terms of MAP, HR, SpO2 and side effects.
CONCLUSIONS
The addition of neostigmine to ropivacaine in IVRA is believed to be a useful effective method for outpatient arm surgery due to a shortened sensory onset time and improved postoperative analgesia.

Keyword

intravenous regional anesthesia; neostigmine; ropivacain e; visual analogue scales

MeSH Terms

Analgesia
Anesthesia, Conduction*
Arm
Arterial Pressure
Forearm
Hand
Heart Rate
Humans
Incidence
Neostigmine*
Outpatients
Neostigmine