Dc. Garciaolmo et al., DOES NEOSTIGMINE HAVE A DELETERIOUS EFFECT ON THE RESISTANCE OF COLONIC ANASTOMOSES, European journal of anaesthesiology, 15(1), 1998, pp. 38-43
The aim of the present study was to evaluate the effects of neostigmin
e as a final anaesthetic manoeuvre on colonic anastomoses. A colonic a
nastomosis was constructed in 40 Sprague-Dawley rats. The animals were
divided into two groups: (1) rats receiving intravenous saline soluti
on (placebo); and (2) rats receiving an intravenous injection of neost
igmine. The size of the caecum, and the diameters of the preanastomoti
c and post-anastomotic colon were measured during the operation and 4
days after surgery, when all the animals were sacrificed. At this time
, the presence of adhesions was also investigated. Each segment contai
ning an anastomosis was removed, and the bursting pressure and burstin
g wall tension were determined. Loss of caecum diameter was significan
tly greater in group 2 than in group 1 (P=0.03). Dilatation and obstru
ction of the colon were significantly more frequent in group 1 (dilata
tion, P=0.01; obstruction, P=0.047). Also, consumption of water by gro
up 2 was greater than that by group 1 (P=0.049). No statistically sign
ificant differences were found between the diameters of the colon (pre
-and post-anastomosis), or with respect to general adhesions and adhes
ions to the anastomotic line. No significant differences were found be
tween anastomotic resistance (determined in terms of bursting pressure
and bursting wall tension) in the two groups. The inclusion of neosti
gmine in an anaesthetic protocol under experimental setting did not re
duce the resistance of colonic anastomoses and did not compromise norm
al healing. Moreover, obstruction caused by peristaltic weakness might
be prevented by the expulsion of stool that is induced by the strong
contraction of the colonic smooth muscle.