Intraarticular neostigmine for postoperative analgesia

The aim of this randomised double-blind study was to assess the analgesic efficacy of intraarticular neostigmine applied postoperatively following arthroscopic procedures of the knee joint. Patients, aged 19 to 70 years, were randomised into two groups. Group I received 500 μg of neostigmine + 10 ml NaCl intraarticularly at the end of surgery, prior to the arthroscope being removed. Group II received 10 ml of physiologic saline intraarticularly. Pain scores were assessed postoperatively using the visual analogue scale (0=no pain, 10=unbearable pain at rest or with activity). In addition, side effects and sedation scores were recorded. Vital signs and the above scores were recorded before the first analgesic request and at 1, 2, 3, 6, 9, 12, 18 and 24 hours postoperatively. For rescue medication patients received a loading dose of morphine hydrochloride postoperatively, followed by patient controlled analgesia.