title: Colonic anastomotic disruption in the immediate postoperative period.
abstract: BACKGROUND
  Muscle relaxation is administered to patients undergoing laparotomy for colonic surgery. At the end of the procedure, relaxation needs to be reversed to facilitate extubation. This may be achieved by administering anticholinesterases such as neostigmine.
  
  
  METHODS
  We present a case of colonic anastomotic dehiscence in the immediate postoperative period following the use of neostigmine to reverse intra-operative muscle relaxation.
  
  
  CONCLUSIONS
  Neostigmine is frequently used to reverse muscle relaxation at the end of colonic surgery. However, the drug should be used with caution as it has been implicated as a cause of early anastomotic disruption.
authors.affiliation: Singleton Hospital, Sketty Lane, Swansea, SA2 8QA, UK. ghirst@doctors.org.uk
authors.forename: G R
authors.initials: GR
authors.lastname: Hirst
authors.forename: S S
authors.initials: SS
authors.lastname: Karandikar
authors.forename: G
authors.initials: G
authors.lastname: Brown
authors.forename: H
authors.initials: H
authors.lastname: Slowey
authors.forename: J
authors.initials: J
authors.lastname: Beynon
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D001279:Atracurium / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors; D002800:Cholinesterase Inhibitors / Q000009:adverse effects*; D003125:Colostomy; D005260:Female; D006801:Humans; D009388:Neostigmine / Q000009:adverse effects*; D009466:Neuromuscular Blocking Agents / Q000037:antagonists & inhibitors; D011184:Postoperative Period; D013529:Surgical Wound Dehiscence / Q000139:chemically induced*; D014945:Wound Healing / Q000187:drug effects
chemical_list: D002800:Cholinesterase Inhibitors; D009466:Neuromuscular Blocking Agents; D001279:Atracurium; D009388:Neostigmine; C101584:cisatracurium