DOI: 10.36347/sjams.2015.v03i08.036

Pages: 2918-2925

Despite advances in the treatment of postoperative pain, many patients still suffer from pain after surgery, probably due to difficulties in balancing an effective postoperative pain treatment regimen with acceptable side effects. Intrathecal analgesia with a variety of drugs is a widely accepted practice for the treatment of both acute and chronic pain. The purpose of this study was to determine whether association of transdermal nitroglycerine would enhance analgesia from a low dose of intrathecal neostigmine in patients undergoing lower abdominal and lower limb surgery during spinal anesthesia with bupivacaine. 120 patients undergoing lower limb or lower abdominal surgery under spinal anaesthesia were randomly divided into four groups to receive hyperbaric bupivacaine alone or with intrathecal neostigmine and /or transdermal nitroglycerine. After the conclusion of surgery, pain was assessed for 24 hours postoperatively with the help of Linear Visual Analogue scale. At the end of 24 hrs, patients were evaluated for average VAS score, time since spinal anaesthesia to first dose of rescue analgesic and total dose of analgesic required. Side effects complained by the patients were recorded throughout the study period. In results Low dose intrathecal neostigmine enhances the postoperative analgesia of intrathecal bupivacaine. This analgesia is greatly increased by application of transdermal nitroglycerine patch without any significant increase in incidence of side effects.