Dehiscence of intestinal anastomoses and anaesthesia

This study, carried out in 62 patients undergoing surgery under general anaesthesia, has evaluated the neostigmine effects on tone and motility of the muscular rectal wall, by recording compliance and manometric values. An increase of intrarectal pressure values in patients antagonized with neostigmine has been evidenced. This finding is related to contracture and increased motility of muscular rectal wall, induced by anticholinesterase agent. In patients eligible for intestinal anastomoses, rapidly eliminated myoneural blocker such as atracurium besylate or vecuronium, should be preferred. These agents allow a spontaneous reversal of the myoneural block, without pharmacologic antagonism.