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Anaesthesia


Title:Combined pre-incisional oral dextromethorphan and epidural lidocaine for postoperative pain reduction and morphine sparing: a randomised double-blind study on day-surgery patients
Author(s):Weinbroum, A. A. Lalayev, G. Yashar, T. Ben-Abraham, R. Niv, D. Flaishon, R.
Address:Department of Anaesthesiology and Critical Care Medicine, Post-Anaesthesia Care Unit, and Pain Clinic, Tel Aviv Sourasky Medical Centre, 6 Weizman Street, Tel Aviv 64239, Israel. graviw@tasmc.health.gov.il
Year:2001 Jul
Journal Title:Anaesthesia
Page Number:616-22
Language:eng
Volume:56
Issue:7
ISSN/ISBN:0003-2409 (Print). 0003-2409 (Linking)
Abstract:The reduction in acute pain perception following dextromethorphan has previously been investigated in patients undergoing general anaesthesia. This random and double-blind study examined the effects of pre-incisional oral dextromethorphan on postoperative pain and intravenous patient-controlled morphine demand in 60 day-surgery patients undergoing lower body surgery under lidocaine (1.6%-16 ml) epidural anaesthesia after receiving placebo, 60 or 90 mg dextromethorphan, 90 min pre-operatively. Postoperative pain was scored on a visual analogue scale from 1 to 10. In-hospital observation continued for 6 h and for 3 days at home; diclofenac was available throughout. Dextromethorphan-treated patients reported significantly (p < 0.05) less pain and sedation, and felt better. Patients who received dextromethorphan 90 mg had significantly (p < 0.05) lower heart and respiratory rates than those who received 60 mg. Medicated patients required half the morphine and diclofenac of placebo patients: 38% of patients who received 90 mg and 21% who received dextromethorphan 60 mg used no morphine or diclofenac whatsoever, a previously unreported finding.

 
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