Related Experiment Video
Updated: May 15, 2025
14:56
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
21.3K
Dextromethorphan as an Opioid-Sparing Analgesic in Postoperative Pain
Ravindrasingh Rajput1, Karim Al Harakeh, Gustavo Figueras
1Department of Pharmacology, American University of Antigua College of Medicine, Osbourn, Antigua and Barbuda.
Clinical Neuropharmacology
|April 8, 2025
Summary
Dextromethorphan shows promise as an opioid-sparing analgesic for postoperative pain, reducing pain scores and opioid needs. Further research is needed to optimize its use in multimodal pain management strategies.
Area of Science:
- Anesthesiology and Pain Management
- Pharmacology
Background:
- Dextromethorphan, primarily a cough suppressant, is gaining attention for its analgesic properties.
- Opioid-sparing analgesics are crucial for managing perioperative pain and mitigating risks associated with opioid use.
Purpose of the Study:
- To review the role of dextromethorphan in perioperative pain management.
- To explore its efficacy in reducing postoperative pain and opioid consumption.
Main Methods:
- Review of clinical trials and existing literature on dextromethorphan's use in pain management.
- Analysis of dextromethorphan's pharmacological mechanisms, including NMDA receptor antagonism and sigma-1 agonism.
Main Results:
- Dextromethorphan effectively reduces pain scores and postoperative opioid requirements.
- Its mechanisms include NMDA receptor antagonism, sigma-1 agonism, and neurotransmitter reuptake inhibition.
- Efficacy may vary across different pain conditions, with limited impact noted in postherpetic neuralgia.
Conclusions:
- Dextromethorphan is a potential adjunct in multimodal analgesia for perioperative pain.
- It can help reduce opioid reliance, contributing to improved patient outcomes and satisfaction.
- Further research is required to establish comprehensive dosing guidelines and fully understand its role in various pain syndromes.
Related Concept Videos
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
183
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...
183
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
145
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
145
01:25Analgesia and Pain Management
403
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
403
01:17Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
135
Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
135
01:22Opioid Receptors: Overview
358
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
358
01:24Parenteral Anesthetics: Overview
87
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.
87