Akademik Veri Yönetim Sistemi
Acta Anaesthesiologica Italica / Anaesthesia and Intensive Care in Italy, cilt.49, sa.3, ss.275-279, 1998 (Scopus)
We investigated whether the addition of neostigmine to bupivacaine prevents the hypotensive effect of bufivacaine-induced hypotension in spinal anesthesia in patients undergoing minor lower extremity surgical procedures. 19 ASA phsyical status I-II were studied. The first 6 patients received bupivacaine 3.0 ml 0.5% plus 100 μgr neostigmine (group I), the second 7 patients received bupivacaine 3.0 ml 0.5% plus 250 μgr neostigmine (group II) and the remaining 6 patients received bupivacaine 3.0 ml 0.5% alone (group III) through a 22 spinal needle intrathecally. Mean arterial pressure (MAP), Heart Rate (HR) and oxyhemoglolin saturation were recorded before the drugs given intrathecally as baseline values and at every 5 min. for 30 min., then at 45, 60, 90, 120, 150, and 180 minutes after the administration of the study drugs intrathecally A decrease in MAP values was observed in group I and III from 25 min. to 45 min, after the study agents were administered intrathecally (p < 0.05). The addition of neostigmine 100 μgr did not affect the hypotension seen after bupivacaine. In contrast, intrathecal bupivacaine 3.0 ml 0.5% plus 250 μgr neostigmine produced an insignificant increase in MAP beginning in 2-3 min. and lasting 45 min., then returned to baseline values. One patient in group I and four patients in group II showed severe emetic symptoms. We concluded that intrathecal neostigmine 250 μgr lessens bupivacaine induced hypotension. We also suggest that despite emetic symptoms, this form of anesthesia can be used safely in hypotensive patients undergoing minor lower extremity surgical procedures.