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 RESEARCH ARTICLE
Year : 2014  |  Volume : 46  |  Issue : 6  |  Page : 613-616

Optimal single-dose epidural neostigmine for postoperative analgesia after partial hepatectomy


Department of Anaesthesia, Zhongshan Hospital, Department of Anesthesiology, Shanghai Medical College, Fudan University, Shanghai, China

Correspondence Address:
Sheng Jin Ge
Department of Anaesthesia, Zhongshan Hospital, Department of Anesthesiology, Shanghai Medical College, Fudan University, Shanghai
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0253-7613.144918

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Objective: Neostigmine can produce analgesia by acting on the spinal cord. This study was to determine the optimal single-dose of epidural neostigmine for postoperative analgesia after partial hepatectomy. Patients and Methods: Twenty-six patients undergoing elective partial hepatectomy under general anesthesia combined with epidural block were studied. The dose of epidural neostigmine was determined using Dixon's up-and-down method, starting from neostigmine 100 μg with an interval of 25 μg. Thirty minutes after skin incision, a predetermined dose of neostigmine was injected via the epidural catheter. Each patient received 0.125% bupivacaine and fentanyl 2 μg/ml for patient controlled epidural analgesia (PCEA) after the operation. Assessment of analgesia quality was performed at 8 h and 24 h after the operation. Results : The ED 50 of epidural neostigmine in combination with PCEA for satisfactory analgesia was 226.78 ± 33.20 μg. Probit analysis showed that the ED 50 and ED 95 of epidural neostigmine were 228.63 μg (95% CI = 197.95-299.77 μg) and 300.12 μg (95% CI = 259.44-741.65 μg), respectively. Conclusion: The ED 50 and ED 95 of epidural neostigmine in combination with PCEA for satisfactory analgesia after partial hepatectomy were 228.63 μg (95% CI = 197.95-299.77 μg) and 300.12 μg (95% CI = 259.44-741.65 μg).






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