A STUDY OF POST OPERATIVE ANALGESIA AND ADVERSE EFFECTS PRODUCED BY INTRATHECAL NEOSTIGMINE, MORPHINE AND THEIR COMBINATION IN PATIENTS UNDERGOING ELECTIVE CAESAREAN SECTION UNDER SPINAL ANAESTHESIA

Abstract

This is a double blind placebo controlled study of 120 patients conducted in the department of anesthesiology POF’s Hospital Wah Cantt: from October 2002 to April 2003 to evaluate the post operative analgesia and side effects of IT neostigmine, morphine and their combination in patients undergoing elective caesarean section under spinal anaesthesia. These patients were randomly divided into neostigmine, morphine, combined and saline (control) groups of 30 patients each. Morphine group had the longest analgesia as compared to other groups. The combined group too had a statistically significant prolongation of analgesia as compared to neostigmine (p = .01) and saline group (p = .00). Nausea and vomiting were more frequent in neostigmine group (53%) and combined group (53%) than in the morphine group (36%) and saline group (26%). The frequency of pruritis was not significantly different in combined (50%) and morphine group (46.66%) This study demonstrates that the combination of IT neostigmine 12.5 microgram and IT morphine 50 microgram results in post operative analgesia for longer duration than IT neostigmine 25 microgram alone but not longer than IT morphine 100 microgram alone. The side effects seen with either drug alone are not over come by combining the drugs in half the doses.