Design: A prospective, randomized, double-blinded, placebo controlled proto
col. Setting: An academic, tertiary care referral center. Patients: Forty r
andomly selected children, ages 3 to 13 years, scheduled for adenotonsillec
tomy without other simultaneous procedures. Intervention: A single, oral do
se of dextromethorphan pediatric cough syrup (1 mg/kg) or placebo given 30
minutes before surgery. Main Outcome Measure: Total dose requirement of int
ravenous 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: Dextromethor
phan syrup is a safe, non-narcotic medication that significantly reduced th
e requirement of intravenous morphine after pediatric adenotonsillectomy, I
ts routine use in this manner is recommended.