Abstract | UNLABELLED: We studied the effect of dextromethorphan, an N-methyl-D-aspartate antagonist, on analgesic consumption and pain scoring after abdominal hysterectomy. In this double-blinded study, 50 patients were randomized into two groups. Group DM was given oral dextromethorphan 40 mg with their premedication, then 40 mg three times per day for the next 2 days. Group P received placebo at identical times. Postoperative analgesic requirements were assessed using a patient-controlled analgesia system and subsequent oral analgesic intake using a set protocol. Pain was assessed at rest and on movement using a visual analog scale 4, 24, 48, and 72 h after the operation. Median pain scores at rest were significantly lower at 48 and 72 h and also for the sum of all resting pain scores. Mean morphine consumption was less in Group DM (1.1 vs 1.5 mg/h; P = 0.054). Usage of oral diclofenac, given every 8 h as needed, did not differ between groups, but consumption of codydramol ( paracetamol 500 mg and dihydrocodeine 10 mg) was significantly less in Group DM. We conclude that the use of oral dextromethorphan has an analgesia-sparing effect and some beneficial effects on pain scoring at rest after abdominal hysterectomy. IMPLICATIONS: Patients given dextromethorphan before and after surgery had a significant reduction in some pain scores at rest, but not on movement. There was a trend to lower morphine requirements in the first 24 h. Over the next 48 h, oral analgesic usage was significantly reduced.
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Authors | D J Henderson, B S Withington, J A Wilson, L M Morrison |
Journal | Anesthesia and analgesia
(Anesth Analg)
Vol. 89
Issue 2
Pg. 399-402
(Aug 1999)
ISSN: 0003-2999 [Print] United States |
PMID | 10439755
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
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Chemical References |
- Analgesics
- Excitatory Amino Acid Antagonists
- N-Methylaspartate
- Dextromethorphan
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Topics |
- Administration, Oral
- Adult
- Analgesics
(therapeutic use)
- Dextromethorphan
(administration & dosage)
- Double-Blind Method
- Drug Administration Schedule
- Excitatory Amino Acid Antagonists
(administration & dosage)
- Female
- Humans
- Hysterectomy
- Middle Aged
- N-Methylaspartate
(antagonists & inhibitors)
- Pain Measurement
- Pain, Postoperative
(drug therapy, prevention & control)
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