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Postoperative analgesic effect of epidural neostigmine and plasma cortisol and IL-6 responses.

Abstract：

STUDY OBJECTIVES:To examine whether epidural administration of neostigmine reduces the stress and inflammatory responses thereby improving postoperative pain status. DESIGN:Randomized, double-blinded clinical study. SETTING:Operating rooms and wards of a university hospital. PATIENTS:40 ASA physical status I patients undergoing lower open abdominal surgery for benign gynecological disease. INTERVENTIONS:Patients were randomly divided into four groups to receive different doses of epidural neostigmine (0, 0.05, 0.1, or 0.15 mg) with mepivacaine (100 mg) before general anesthesia induction. MEASUREMENTS:The plasma levels of cortisol and interleukin-6 (IL-6) were determined perioperatively. The patients' pain rating was assessed by visual analog scale (VAS) in the postoperative period. MAIN RESULTS:Epidural neostigmine at all doses significantly reduced the plasma levels of cortisol in the early surgical period; however, IL-6 levels were not affected by the neostigmine. The VAS scores were significantly decreased at 2 hours after the end of surgery by all doses of epidural neostigmine used in this study. CONCLUSIONS:The preincisional epidural neostigmine transiently suppresses the stress responses during surgery and improves postoperative analgesia in patients undergoing lower open abdominal surgery.

journal_name

J Clin Anesth

journal_title

Journal of clinical anesthesia

authors

Masaki E,Saito H,Shoji K,Matsushima M

doi

10.1016/j.jclinane.2003.12.009

subject

Has Abstract

pub_date

2004-11-01 00:00:00

pages

488-92

issue

7

eissn

0952-8180

issn

1873-4529

pii

S0952818004001242

journal_volume

16

pub_type

临床试验,杂志文章,随机对照试验

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