A comparison of post operative analgesia and adverse effectsproduced by neostigmine and morphine when given intrathecally

Various modalities had been tried for optimum duration of post operative analgesia with minimal side effects. The present study was undertaken to evaluate the duration and quality of post operative analgesia by intrathecal bupivacaine alone, intrathecal bupivacaine12.5mg (0.5% heavy) with neostigmine (50μg) or intrathecal bupivacaine12.5mg (0.5% heavy) with morphine (100μg) in spinal block. 150 patients of ASA physical status 1&2, age 20–70 years of either sex, body weight 50100Kg were randomally assigned in three study groups. Group I -0.5% bupivacaine (2.5ml bupivacaine+0.5ml normal saline), group II - 0.5% bupivacaine with 50μg neostigmine (2.5ml bupivacaine+0.5ml neostigmine) and group III - 0.5% bupivacaine with morphine100μg (2.5 ml bupivacaine+0.5 ml morphine). Onset of sensory and motor block of intrathecal neostigmine and intrathecal morphine group was much faster as compare to control group. Duration of post operative analgesia was also more in intrathecal neostigmine and intrathecal morphine group as compare to control group. Intrathecal neostigmine and intrathecal morphine groups were comparable in terms of onset of sensory and motor block and level of highest block. Nausea, vomiting and bradycardia were more in neostigmine group as compare to intrathecal morphine and control group. Patients in intrathecal morphine group had more incidence of pruritus. We concluded that intrathecal morphine 100μg is a better choice than intrathecal neostigmine during spinal block.