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Premedication with dextromethorphan provides posthemorrhoidectomy pain relief
1Section of Anesthesia, Armed Forces Sung-Shang Hospital, Taipei, Taiwan, Republic of China.
Diseases of the Colon and Rectum
|May 2, 2000
Summary
Dextromethorphan premedication significantly reduced postoperative pain and the need for pethidine in hemorrhoidectomy patients. This N-methyl-D-aspartate antagonist improved recovery and minimized side effects.
Area of Science:
- Anesthesiology
- Pharmacology
- Pain Management
Background:
- N-methyl-D-aspartate (NMDA) receptor antagonists are known for preemptive analgesic effects.
- Dextromethorphan is an NMDA antagonist with potential for improved postoperative pain management.
Purpose of the Study:
- To evaluate the preemptive analgesic effect of dextromethorphan premedication.
- To assess its impact on postoperative pain and pethidine requirements after hemorrhoidectomy.
Main Methods:
- A randomized study of 60 patients undergoing hemorrhoidectomy.
- Premedication with either dextromethorphan (40 mg) or a placebo (chlorpheniramine maleate) 30 minutes before surgery.
- Postoperative pain assessed by time to first pethidine injection, total pethidine consumption, and visual analog scale (VAS) pain scores over 48 hours.
Main Results:
- Patients receiving dextromethorphan had a significantly longer time to first pethidine injection (19.6 vs. 5.2 hours).
- Total pethidine consumption was reduced by over 50% in the dextromethorphan group (63.5 vs. 140 mg).
- Worst VAS pain scores were lower (5.6 vs. 7.4), and fewer patients required pethidine, with no reported side effects in the dextromethorphan group.
Conclusions:
- Dextromethorphan premedication demonstrates a significant preemptive analgesic effect.
- It effectively reduces postoperative pain, opioid consumption, and side effects following hemorrhoidectomy.
- Dextromethorphan improves patient recovery and pain management after this surgical procedure.