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 mu g with an interval of 25 mu g. 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 mu g/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 ED50 of epidural neostigmine in combination with PCEA for satisfactory analgesia was 226.78 +/- 33.20 mu g. Probit analysis showed that the ED50 and ED95 of epidural neostigmine were 228.63 mu g (95% CI = 197.95-299.77 mu g) and 300.12 mu g (95% CI = 259.44-741.65 mu g), respectively. Conclusion: The ED50 and ED95 of epidural neostigmine in combination with PCEA for satisfactory analgesia after partial hepatectomy were 228.63 mu g (95% CI = 197.95-299.77 mu g) and 300.12 mu g (95% CI = 259.44-741.65 mu g).
[1]Fudan Univ, Zhongshan Hosp, Shanghai Med Coll, Dept Anaesthesia,Dept Anesthesiol, Shanghai 200433, Peoples R China.
(8.0+极速模式)