Yy. Chia et al., The preoperative administration of intravenous dextromethorphan reduces postoperative morphine consumption, ANESTH ANAL, 89(3), 1999, pp. 748-752
Citations number
21
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
We evaluated the effect of dextromethorphan on postoperative pain managemen
t. Sixty ASA physical status I-III female patients undergoing major abdomin
al surgery underwent standardized general anesthesia. Thirty patients recei
ved an IV infusion of dextromethorphan 5 mg/kg before anesthetic induction
(Pre group), whereas the remaining 30 patients received the same volume of
isotonic sodium chloride solution, followed by a postoperative IV infusion
of dextromethorphan 5 mg/kg (Post group). Patients in the Pre group receive
d the same volume of isotonic sodium chloride solution postoperatively. All
patients were then treated with patient-controlled TV analgesia, which adm
inistered a 0.6-mg bolus of morphine on demand (maximal 4 h dose 20 mg). Th
e mean visual analog pain score during cough or movement and at rest were s
imilar in the two groups in the first 3 days postoperatively. However, Post
group patients consumed more morphine than Pre group patients during the f
irst 2 days (P < 0.01). The sedation scores, patient satisfaction, and the
incidence of morphine-related side effects were similar between the two gro
ups. We conclude that the preoperative administration of dextromethorphan 5
mg/kg reduces postoperative morphine consumption compared with postoperati
ve administration. Implications: In this double-blinded study, we found tha
t the preoperative administration of IV dextromethorphan 5 mg/kg, compared
with postoperative administration, reduces postoperative morphine consumpti
on, which may provide clinical evidence of preemptive or preventive analges
ic effects of dextromethorphan.