Comparing the effectiveness of intrathecal injection of marcaine with magnesium sulfate, neostigmine or phentanyl on post-operative pain, urinary retention, nausea or vomiting in patients undergoing spinal anesthesia for lumbar disk herniation surgery

Abstract

Background: Pain is one of the major post-operative problems that patients encounter in lumbar discectomy surgery with usually a devastating effect on the patient's spirit within the first 24 hours after surgery. This study aimed to compare the effect of intrathecal injection an admixture containing Marcaine and magnesium Sulfate with that of Neostigmine and Fentanyl on the duration of analgesia, nausea and vomiting, urinary retention and the dose of analgesic in lumbar disc herniation. Methods: This clinical trial study was conducted in Isfahan, Iran, Al-Zahra University Hospital in 2012 on patients with lumbar disc herniation undergoing surgery. Patients were randomly divided into three groups and were spinally anesthetized. Marcaine with Magnesium Sulfate were used for the first group, Neostigmine for the second group, and Fentanyl for the third group at the time of injection. After the surgery, a collection of patient’s signs and symptoms including pain in surgical site, urinary retention, patient request for additional intravenous morphine and nausea and vomiting were assessed and recorded every 6 hours for 24 hours. The obtained findings were analyzed using SPSS software. Findings: The mean pain intensity, nausea and vomiting and urinary retention had no significant difference in all three studied groups from 2 to 24 hours after the operation. Conclusion: Adding Magnesium Sulfate, Neostigmine or Fentanyl had no effect on reducing the postoperative complications and all the three compounds had a similar effect on pain and other postoperative complications and given the patient conditions and comments of the anesthesiologist and surgeon, each drug can be used to control pain and reduce the postoperative complications. © 2016, Isfahan University of Medical Sciences(IUMS). All rights reserved.