Comparative Studv of IntrathecalNeostigmine Ve sus IntrathecalClonidine, and their Combination for Postoperative Analgesia in Patients Undergoing lower AbdominalSurgery

Abstract

Postoperative pain is a great problem which deserves a great consideration. Pain becomes a predictable response as the effect of anesthetics subsides in the early postoperative period. The perception of pain in patients who have not regained full consciousness and self-control may manifest as agitation (emergence delirium). Adverse effects of postoperative pain include increased postoperative morbidity, delayed resumption of normal pulmonary functions, restriction of mobility (with thrombo-embolic complications), and heightened catecholamine response with increase cardiac work load. Many of these effects can be eliminated or reduced by controlling postoperative pain. Recent research has demonstrated the importance of spinal cord in processing and modulating nociceptive stimuli through the administration of epidural or intrathecal drugs. Unfortunately, non of the currently used spinally administered analgesics can produce analgesia without side-effects (e.g. hemodynamic instability, motor weakness, urine retention, respiratory depression, and postoperative nausea and vomiting).