This study evaluated the efficacy of an epidural single dose of neostigmine combined with fentanyl to provide postoperative analgesia after radical subtotal gastrectomy.

Fifty two adults patients with ASA physical status 1 and 2 are randomly allocated to receive a single injection of either epidural fentanyl 100µg or combination of fentanyl 100µg with neostigmine 250, 500 and 750µg in 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.

Patients' demographic data were not different from each other. Epidural neostigmine 750µg with fentanyl 100µg 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 (250µg: 84.2 ± 9.4, 500µg: 90.9 ± 7.1, 750µg: 92.5 ± 14.4 min) than the control group (53.0 ± 20.0 min).

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 750µg.