“Comparative Evaluation of Intrathecal Neostigmine with Intrathecal Fentanyl for Post- operative Pain Relief”

Background: Anticholinesterases increase the concentration of acetylcholine at the postsynaptic sites which cause prolonged analgesia. Aims Objectives: To evaluate and compare the effects of intrathecal neostigmine and intrathecal fentanyl on post-operative pain relief. Materials and Methods: After informed consent, 60 female patients of age between 40 and 60 years, belonging to ASA Grades 1 and 2, posted for TAH under spinal anesthesia were included in the study and randomly divided into 2 groups of 30 each. Patients of Group 1 received intrathecal injection of bupivacaine 0.5% 15 mg (3 ml) with 5 μg neostigmine, and Group 2 received intrathecal injection of bupivacaine 0.5% 15 mg (3 ml) with 25 μg fentanyl. Results: The mean duration of analgesia in Groups 1 and 2 was 594.67±95.18 min and 309.67±44.91 min, respectively. It was observed that duration of analgesia in Group 1 was longer and statistical significant in comparison to Group 2. Conclusion: Intrathecal neostigmine provides prolonged post-operative analgesia than intrathecal fantanyl with less side effect and better hemodynamic stability.