The addition of neostigmine to epidural analgesia during labor is an effective treatment option for reducing the amount of required anesthetic drug, as per a study appearing in an issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

The Journal, which was published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health that is believed to be one of the leading information and business intelligence providers by students, institutions, and professionals in the world of pharmacy and nursing.

From News-Medical.Net:

Anesthesiologists in developed countries primarily provide analgesia for women in labor by giving them an epidural anesthetic, which blocks the pain of labor contractions from reaching the spinal cord and brain. Epidural anesthesia almost always consists of a cocktail comprised of a local anesthetic, such as bupivacaine, and a morphine-like drug, such as fentanyl. However, these opioid drugs can cause significant side effects, including abnormalities of the fetal heart rate.

The new study suggests that adding neostigmine instead of opioids can improve the quality of epidural pain relief for women in labor, while decreasing the amount of local anesthetic required. “This represents an important advance in providing safe and effective pain relief for women in labor, because it may allow anesthesiologists to replace the morphine-like drugs with less toxic drugs such as neostigmine,” according to an accompanying editorial by Dr. Cynthia Wong of Northwestern University, Chicago. However, Dr. Eisenach notes that large safety studies are still needed provide assurance that neostigmine itself has an adequate safety profile to permit widespread clinical use.

Neostigmine could prove to be effective for improving the quality of epidural pain relief, as per a study led by Dr. James Eisenach of Wake Forest University School of Medicine, Winston-Salem, N.C.

Tags: epidural analgesia, neostigmine, opioid drugs

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