Evaluation of intravenous neostigmine infusion on tolerance of enteral nutrition in Intensive Care Unit patients

Based on the dramatic response of acute colonic pseudo-obstruction to neostigmine, we designed this study to evaluate the effect of neostigmine on the tolerance of enteral feeding in Intensive Care Unit (ICU) patients. A total of 60 patients hospitalized in the ICU of Alzahra Hospital, Isfahan, Iran entered the study. They were randomly assigned to one of the two groups of case (who received intravenous neostigmine infusion) and control (normal saline). They were compared with respect to incidence of constipation, diarrhea, and vomiting. Arrhythmia, bronchospasm, mean arterial blood pressure (MAP), and heart rate (HR) were also evaluated at 0, 4, 8, 12, 16, 20, and 24 h. The frequency distribution of constipation, diarrhea, vomiting, and increase in gastric lavage volume in the intervention group was 20%, 33.3%, 46.7% and 43.3%, while these indices in the control group were 40%, 30%, 43.3%, and 63.3%, respectively (P > 0.05). Arrhythmia was observed in 3% and 6% in the case and control groups, respectively. Bronchospasm was not detected in any of patients. There was no significance difference between neostigmine and normal saline with respect to tolerance of enteral nutrition in ICU patients.