ABSTRACT
BACKGROUND: This study evaluated the efficacy of an epidural single dose of neostigmine combined with fentanyl to provide postoperative analgesia after radical subtotal gastrectomy. METHODS: Fifty two adults patients with ASA physical status 1 and 2 are randomly allocated to receive a single injection of either epidural fentanyl 100 microgramor combination of fentanyl 100microgram with neostigmine 250, 500 and 750microgramin a total volume of 10 ml. Pain scores were recorded after 0, 5, 10, 15, 20, 30 mins to determine the onset of analgesia. Patients' vital signs as well as side effects were monitored at regular intervals. RESULTS: Patients' demographic data were not different from each other. Epidural neostigmine 750 microgram with fentanyl 100 microgram produced effective analgesia (visual analog scale at 10 min ; 35 +/- 10.6 mm). The time to first rescue analgesics administration was significantly longer in the neostigmine group (250 microgram: 84.2 +/- 9.4, 500 microgram: 90.9 +/- 7.1, 750 microgram: 92.5 +/- 14.4 min) than the control group (53.0 +/- 20.0 min). CONCLUSIONS: Combination of fentanyl with neostigmine was proven to be more effective for treating postoperative pain after subtotal gastrectomy than fentanyl alone. Additionally, the most effective dose of epidural neostigmine was 750microgram.