Korean J Anesthesiol.  2005 Feb;48(2):171-176. 10.4097/kjae.2005.48.2.171.

Effects of Epidural Neostigmine on Postoperative Analgesia and Stress Responses after Gastrectomy

• Chung CJ
• Shin HS
• Lee SC
• Lee JH
• Chin YJ

• KMID: 2238381
• DOI: http://doi.org/10.4097/kjae.2005.48.2.171

Abstract

BACKGROUND: Intrathecal or epidural neostigmine has a postoperative analgesic effect. In this study we evaluated the effects of epidural neostigmine on postoperative analgesia and stress responses after gastrectomy.
METHODS
Eighty, ASA physical status 1 or 2, patients scheduled for gastrectomy were randomly assigned to one (n = 20) of four groups. Patients received 5 ml of 0.25% bupivacaine with either saline (N0 group), neostigmine 5microgram/kg (N5 group), neostigmine 10microgram/kg (N10 group), neostigmine 15microgram/kg (N15 group) epidurally 30 minutes before operation. All patients received identical general anesthesia. Patient-controlled epidural analgesia (PCEA) was provided by bupivacaine (0.05%) and fentanyl (4 microgram/ml) for postoperative analgesia.
RESULTS
The N10 and N15 groups showed reduced 24-h PCEA consumptions compared with the N0 and N5 groups (P < 0.05). No differences in visual analog pain scores at rest or during movement were observed between the groups. The concentrations of plasma cortisol, epinephrine, norepinephrine and glucose did not differ among the four groups, and their incidences of postoperative adverse effects were similar.
CONCLUSIONS
Epidural neostigmine 10 and 15microgram/kg in bupivacaine produced a postoperative analgesic effect, but did not suppress stress responses after gastrectomy

Keyword

epidural neostigmine; gastrectomy; postoperative analgesia; stress response

MeSH Terms

Analgesia*
Analgesia, Epidural
Anesthesia, General
Bupivacaine
Epinephrine
Fentanyl
Gastrectomy*
Glucose
Humans
Hydrocortisone
Incidence
Neostigmine*
Norepinephrine
Plasma
Bupivacaine
Epinephrine
Fentanyl
Glucose
Hydrocortisone
Neostigmine
Norepinephrine