Neostigmine added to lidocaine axillary plexus block for postoperative analgesia.
OBJECTIVE
We have assessed the analgesic efficacy and side-effects of neostigmine when added to lidocaine for axillary brachial plexus block, in a prospective, randomized, double-blind, placebo-controlled study.


METHODS
We studied 34 ASA I or II patients undergoing elective ambulatory carpal tunnel release. Axillary brachial plexus block was performed using a peripheral nerve stimulator to locate the median nerve. All patients were administered 1.5% lidocaine 450 mg and epinephrine 5 microg mL-1. Patients were allocated randomly to one of two groups. Neostigmine 500 microg was added in group N, and saline 1 mL in group S.


RESULTS
The duration of analgesia did not significantly differ between groups [mean (SD)]: 812.5 (456.9) for group S vs. 746.7 (474.1) min for group N (P > 0.05). The need for supplementary analgesia did not significantly differ between groups: 4.4 (1.5) extra doses for group S vs. 3.8 (2.2) extra doses for group N (P > 0.05). Visual analogue pain scores and occurrence of side-effects did not significantly differ between groups.


CONCLUSIONS
Neostigmine does not seem to be of clinical value for peripheral nerve blocks.
Van Elstraete
A C
AC
Department of Anaesthesiology, Saint-Paul Medical Center, University Hospital, Fort-de-France, Martinique, France.
Pastureau
F
F
Lebrun
T
T
Mehdaoui
H
H
D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009388:Neostigmine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D009407:Nerve Block; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies
D000779:Anesthetics, Local; D002800:Cholinesterase Inhibitors; D009388:Neostigmine; D008012:Lidocaine