Volume 7, Number 1 (10-2016)                   JAP 2016, 7(1): 61-67 | Back to browse issues page

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Compare the effect of adding ketamine and Neostigmine to bupivacaine ‎‎0.25 % for epidural analgesiain patients candidate for elective surgery‎. JAP. 2016; 7 (1) :61-67
URL: http://jap.iums.ac.ir/article-1-5305-en.html

Abstract:   (633 Views)

Background:Pain is a complex medical problem that its inadequate control of postoperative has adverse effects onpatients physiological , metabolic and mentalstatus. Adding new supplements will lead to an increased duration of analgesia . The purpose of this study was to compare the addition of neostigmine and ketamine to bupivacaine 0.25% for epidural analgesiainincreasing duration ofpostoperative analgesia.
Materials and Methods:In this double blind clinical trial, 90 patients over 50 years candidate for elective hip surgerywith ASA class I, II randomly divided to three groups: neostigmine , ketamine and control groups. All patients received epidural with bupivacaine 0.25% by 2cc/segment .Furthermore 60 micrograms neostigmineadded in first group and 40 mg ketamine ingroup II . Level of postoperative pain based on VAS and duration of analgesia and amount of analgesic determined and compared between the three groups .
Results:The mean of  pain score at 6 and 12 hours after surgery was significantly lower in the ketamine group than the other groups and in neostigmine group was less than placebo( P ≤ 0.01). The mean of duration of postoperative analgesia in the ketamine group was significantly higher than the other groups and in neostigmine group was more than placebo(P ≤ 0.01). The mean dose of analgesic (pethedin)  wasthe least in the ketamine group (P ≤ 0.001).
Conclusion:Neostigmine and ketamine with bupivacaine 0.25% for epidural anesthesia increased the duration of analgesia for postoperative and reduced analgesicconsumption that  about ketaminewas more than neostigmine .

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Type of Study: Original | Subject: Regional anesthesia
Received: 2016.09.21 | Accepted: 2016.10.29 | Published: 2016.12.16

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