Evidence map›Paper›PMID 40425252›Full record

ArticleBMJ open2025

Analgesic effects of intrathecal bupivacaine with neostigmine or morphine among elective surgical patients in selected comprehensive specialised hospitals, Southern Ethiopia: a prospective cohort study.

Nesredin Shemsu Delmolo, Temesgen Sidamo, Ashagrie Sintayehu, Selman Reshad, Abdulkadir Kedir, Mebratu Kebede, Mebratu Tila, Sintayehu Samuel, Rashed Edris Usure, Nuredin Chura Waritu and 2 more

Abstract readMulticenter StudyComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Nesredin Shemsu DelmoloSchool of Anesthesia, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia nurmaye12@gmail.com nshemsu2022@gmail.com.
Temesgen SidamoSchool of Pharmacy, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
Ashagrie SintayehuSchool of Anesthesia, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
Selman ReshadDepartment of Anesthsia, Wachemo University, Hossana, Ethiopia.
Abdulkadir KedirSchool of Anesthesia, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
Mebratu KebedeSchool of Anesthesia, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
Mebratu TilaSchool of Anesthesia, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
Sintayehu SamuelDepartment of Anesthsia, Wachemo University, Hossana, Ethiopia.
Rashed Edris UsureDepartment of Pharmaceutical Chemistry, School of Pharmacy, Hawassa University, Hawassa, Ethiopia.
Nuredin Chura WarituDepartment of Biomedical Sciences, School of Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia nurmaye12@gmail.com nshemsu2022@gmail.com.ORCID http://orcid.org/0009-0000-1468-4640
Mohammed JemalDepartment of Biomedical Sciences, School of medicine, Debre Markos University, Debre Markos, Ethiopia.ORCID http://orcid.org/0009-0000-6700-9972
Getahun DendirSchool of Anesthesia, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo compare the analgesic effects of intrathecal neostigmine with bupivacaine, morphine with bupivacaine and bupivacaine alone among patients undergoing surgical procedures below the umbilicus. DESIGN AND

settingA multicentre prospective cohort study was conducted from 29 May to 29 August 2023 at Wolaita Sodo University Comprehensive Specialized Hospital, Nigest Mohammed Eleni Memorial Comprehensive Specialized Hospital and Werabe Comprehensive Specialized Hospital. A systematic random sampling technique was used to select the participants from the sample of 180.

participantsThe study included American Society of Anesthesiologists classes I and II patients aged 18-85 years scheduled for elective surgeries under spinal anaesthesia with bupivacaine with neostigmine (50 µg), bupivacaine with morphine (100 µg) and bupivacaine alone at a dose of 17.5 mg. THE PRIMARY OUTCOME MEASURES: The duration of pain relief, the severity of pain and the time of first analgesic requirement. THE SECONDARY OUTCOME MEASURES: Postoperative complications such as respiratory depression, pruritus, nausea and vomiting

resultsAdministration of intrathecal bupivacaine with neostigmine group (NG) and morphine group (MG), respectively, produces a long duration of postoperative analgesia with a first analgesia request mean time of 9.4±3.18 and 9.65±4.9, while using bupivacaine group (BG) alone produces a shorter duration of postoperative analgesia with a mean first analgesia request time of 3.58±0.98 hours. The mean visual analog scale scores in 28 hours were 0.99, 0.79 and 2.05 for the NG, MG and BG, respectively. The overall postoperative pain severity was highest in the BG. The mean total analgesic consumption was 77.5, 73.8 and 189.2 mg for diclofenac, whereas 54.2, 63.9 and 151.7 mg for tramadol in the NG, MG and BG, respectively. Incidence of nausea (31.3%) and vomiting (30%) was highest in the NG, while pruritus (15%) and respiratory depression (15%) were more in the MG.

conclusionCompared with BG, MG and NG had longer-lasting postoperative analgesic effects, less severe pain and required fewer analgesics overall. Patients in the NG had more incidences of nausea and vomiting. The incidences of pruritus and respiratory depression were highest in the MG. Effective analgesia appeared to work better in the MG and NG. We recommend morphine and neostigmine as adjuvants to local anaesthetics for effective postoperative analgesia. We also recommend researchers compare different doses of neostigmine and morphine as adjuvants to bupivacaine in further studies.

Indexed as

Analgesics, OpioidAnesthetics, LocalBupivacaineElective Surgical ProceduresMorphineNeostigminePostoperative PainAdolescentAdultAgedAged, 80 and overAnesthesia, SpinalEthiopiaFemaleHumansInjections, SpinalAnalgesics, OpioidAnesthetics, LocalBupivacaineMorphineNeostigmineACCIDENT & EMERGENCY MEDICINEAnaesthesia in obstetricsEthiopiaMedicinePain managementTrauma

Identifiers

PMID40425252
PMCPMC12107559

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