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Anesth Pain Med. 2013 Dec 26;4(1):e11187. doi: 10.5812/aapm.11187. eCollection 2014.

Effects of preoperative use of oral dextromethorphan on postoperative need for analgesics in patients with knee arthroscopy.

Author information

  • 1Department of Anesthesiology, Rasoul Akram Medical Center, Iran University of Medical Sciences, Tehran, Iran.
  • 2Department of Orthopedic, Faculty of Medicine, Baqiyatallah University of Medical Sciences , Tehran, Iran.
  • 3Department of Physiology, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran.

Abstract

BACKGROUND:

Studies have shown that N-methyl-D-aspartate receptor (NMIDA) plays an essential role in postoperative pain. It seems that use of NMDA receptor antagonists such as Dextromethorphan intensifies the analgesic effects of opioids.

OBJECTIVES:

In this study, we evaluated the effect of preoperative administration of Dextromethorphan on postoperative pain reduction.

PATIENTS AND METHODS:

This double blind randomized clinical trial was conducted on arthroscopic surgery candidates. Participants were randomly allocated to interventions and assigned to two groups of Dextromethorphan and placebo. In Dextromethorphan group, the patients received 1 mg/kg Dextromethorphan orally the night before the operation. Pain severity based on the visual analog scale (VAS) up to 16 hours postoperation, use of opioids, and the first request for analgesics were recorded postoperatively.

RESULTS:

A total of 112 patients in the Dextromethorphan (n = 54) and placebo groups (n = 58) were evaluated. No significant difference was detected between the two groups for age, sex or ASA. The mean amount of opioid consumption was significantly lower in patients who received Dextromethorphan (10.7 ± 5.6 mg) compared to the placebo group (13.1 ± 5.6 mg), (P = 0.03). The mean time until the first opioid request in patients who received Dextromethorphan was longer than that in the placebo group (P = 0.01).

CONCLUSIONS:

The study results demonstrated that preemptive use of Dextromethorphan reduced postoperative pain and opioid consumption.

KEYWORDS:

Analgesia; Analgesics, Opioid; Pain; Postoperative Period

PMID:
24660143
[PubMed]
PMCID:
PMC3961019
Free PMC Article
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