Related Experiment Videos

Oral dextromethorphan reduces perioperative analgesic administration in children undergoing tympanomastoid surgery

Rashed A Hasan1, Jack M Kartush, John D Thomas

  • 1Michigan State University, Southfield, MI, USA. rashedh48@hotmail.com

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|November 4, 2004
PubMed

Insights

Premedicating children with dextromethorphan (DM) before tympanomastoid surgery significantly reduced opioid use during and after the procedure. This approach also lowered pain scores in the perioperative period.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pharmacology

Background:

  • Opioid administration is common in pediatric surgery.
  • Effective pain management strategies are crucial for pediatric patients undergoing tympanomastoid surgery.

Purpose of the Study:

  • To evaluate the efficacy of oral dextromethorphan (DM) as a premedication in reducing perioperative opioid requirements in children undergoing tympanomastoid surgery.

Main Methods:

  • A prospective, randomized, double-blind, placebo-controlled study involving 38 children.
  • Participants received either dextromethorphan (1 mg/kg) or placebo one hour before surgery.
  • Pain was assessed using a visual analogue scale; opioid administration (fentanyl, morphine) was recorded.

Main Results:

  • The dextromethorphan group required significantly lower doses of intraoperative fentanyl and postoperative morphine compared to the placebo group.
  • Children receiving dextromethorphan reported lower pain scores in the Post-Anesthesia Care Unit and Day Surgery Unit.
  • The reduction in opioid administration and pain scores was statistically significant (P < 0.05).

Conclusions:

  • Oral dextromethorphan premedication is effective in decreasing opioid consumption during the perioperative period for pediatric tympanomastoid surgery.
  • DM can be a valuable adjunct in multimodal analgesia for pediatric surgical patients.
Abstract

Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Upper Respiratory Drugs: Antitussives, Expectorants, and Mucolytics01:23

Upper Respiratory Drugs: Antitussives, Expectorants, and Mucolytics

Respiratory symptoms, such as congestion and cough, commonly accompany respiratory tract conditions. Various medications, such as antitussives, expectorants, and mucolytics, play crucial roles in providing relief.
Antitussives include codeine, dextromethorphan (Robitussin), and benzonatate (Tessalon). Codeine and dextromethorphan exert their effects centrally by suppressing the cough reflex center in the medulla.  Benzonatate operates peripherally within the respiratory tract by anesthetizing...
Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx as...
Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...