Improved postoperative pain control in pediatric adenotonsillectomy with dextromethorphan.

Abstract

DESIGN:

A prospective, randomized, double-blinded, placebo-controlled protocol.

SETTING:

An academic, tertiary care referral center.

PATIENTS:

Forty randomly selected children, ages 3 to 13 years, scheduled for adenotonsillectomy without other simultaneous procedures.

INTERVENTION:

A single, oral dose of dextromethorphan pediatric cough syrup (1 mg/kg) or placebo given 30 minutes before surgery.

MAIN OUTCOME MEASURE:

Total dose requirement of intravenous morphine within a 6-hour postoperative observation period.

RESULTS:

During routine postoperative observation, significantly fewer patients in the dextromethorphan group required no intravenous morphine compared with the placebo group (P =.03). Of those children requiring morphine, the mean dose requirement was significantly lower in the dextromethorphan group (P =.02). There was no known drug-related morbidity.

CONCLUSION:

Dextromethorphan syrup is a safe, non-narcotic medication that significantly reduced the requirement of intravenous morphine after pediatric adenotonsillectomy. Its routine use in this manner is recommended.

• Authors: G S Dawson, P Seidman, H H Ramadan
• Journal: The Laryngoscope (Laryngoscope) Vol. 111 Issue 7 Pg. 1223-6 (Jul 2001) ISSN: 0023-852X [Print] United States
• PMID: 11568544 (Publication Type: Clinical Trial, Comparative Study, Controlled Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Excitatory Amino Acid Antagonists
• Placebos
• Dextromethorphan
• Morphine

Topics

• Adenoidectomy
• Administration, Oral
• Age Factors
• Child
• Child, Preschool
• Data Interpretation, Statistical
• Dextromethorphan (administration & dosage, therapeutic use)
• Double-Blind Method
• Excitatory Amino Acid Antagonists (administration & dosage, therapeutic use)
• Female
• Humans
• Injections, Intravenous
• Male
• Morphine (administration & dosage)
• Pain, Postoperative (drug therapy, prevention & control)
• Placebos
• Prospective Studies
• Tonsillectomy