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Optimal single-dose epidural neostigmine for postoperative analgesia after partial hepatectomy
Qiao Sheng Zhong1, Sheng Jin Ge1, Bei Wang1
1Department of Anaesthesia, Zhongshan Hospital, Department of Anesthesiology, Shanghai Medical College, Fudan University, Shanghai, China.
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 ED50 of epidural neostigmine in combination with PCEA for satisfactory analgesia was 226.78 ± 33.20 μg. Probit analysis showed that the ED50 and ED95 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 ED50 and ED95 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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