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Effects on Security of Colonic Anastomoses

Albert E. Yellin, MD; James Newman, MD; Arthur J. Donovan, MD

AMA Arch Surg. 1973;106(6):779-784.

Abstract
Neostigmine methylsulfate, a muscarinic drug, is frequently employed to reverse the paralytic effect of curare at the conclusion of surgical procedures. The experiments reported document the potent muscarinic effect of neostigmine on the large bowel, causing intraluminal colonic pressure to rise 15 times above base line. This is accompanied by severe spasm, associated with foreshortening and hypersegmentation of the bowel. The prior administration of atropine sulfate, an antimuscarinic drug, in the dose customarily employed during anesthesia, does not ameliorate or abolish the muscarinic effect of neostigmine on the canine colon. The muscarinic effects of neostigmine did not result in the disruption of an anastomosis fashioned in the canine colon.

Author Affiliations
Los Angeles

From the Department of Surgery, University of Southern California School of Medicine, Los Angeles.

Footnotes
Accepted for publication March 2, 1973.

Read before the annual meeting of the Southern California Chapter of the American College of Surgeons, Newport Beach, Calif, Jan 19, 1973.

Reprint requests to Department of Surgery, University of Southern California School of Medicine, 1200 N State St, Los Angeles 90033 (Dr. Yellin).

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