Analgesic effect of dextromethorphan after abdominal gynecologic surgery
- Author:
David Dennis Augusto A.
- Publication Type:Journal Article
- MeSH:
Human;
Female;
Aged;
Middle Aged;
Adult;
HYPERALGESIA;
DEXTROMETHORPHAN;
GYNECOLOGIC SURGICAL PROCEDURES;
PAIN, POSTOPERATIVE
- From:
Philippine Journal of Anesthesiology
2002;14(1):23-27
- CountryPhilippines
- Language:English
-
Abstract:
Backgound: The effect of dextromethorphan, an N-methyl d-aspartate (NMDA) antagonist, on the analgesic consumption and pain scoring after abdominal gynecologic surgery was studied.
Methods: In this double-blind study, 60 patients were randomized into 2 groups. The study group was given oral dextromethorphan 25 mg 8 hours before the scheduled operation and one hour before the operation. Patients in the control group were given placebo capsules at the same intervals. Both groups of patients were given diclofenac sodium 75 mg i.m. prior to transfer to the post anesthesia care unit, and every twelve hours thereafter for a total of three doses. The study group was given dextromethorphan eight hours after the last dose prior to operation and every eight hours thereafter for the next 24 hours. The control group received placebo capsules at the same intervals. Visual analog pain scores were recorded preoperatively and at 4,8,12 and 24 hours postoperatively with the patient supine and coughing.
Results: The mean VAS scores for the two groups, during rest and coughing, at 4 hours of observation, showed no significant difference. However, at 8 hours until 24 hours of observation, a significant difference was noted. Results of this study show that administration of dextromethorphan 25 mg orally preoperatively and postoperatively provides an adjuvant analgesic effect, as evidenced by lesser opioid requirements and lower resting and coughing VAS pain scores postoperatively.
Conclusion: These results imply that the development of central hyperalgesia in the spinal cord induced by nociceptive stimulation of surgery was either blocked or modulated by dextromethorphan acting on NMDA receptors. The nonsedating property and lack of adverse side effects of dextromethorphan make it a promising alternative analgesic to other commonly used drugs.
