British Journal of Anaesthesia, Vol 81, Issue 5 731-736, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia
P. M. McConaghy, P. McSorley, W. McCaughey and W. I. Campbell
Dextromethorphan is an N-methyl-D-aspartate (NMDA) receptor antagonist
which has been shown to inhibit the development of cutaneous secondary
hyperalgesia after tissue trauma. We studied 60 ASA I-II patients
undergoing total abdominal hysterectomy in a randomized, double-blind,
placebo-controlled study. Patients received either dextromethorphan 27 mg
capsules, two doses before operation and three doses in the first 24 h
after operation, or placebo. Visual analogue pain scores (VAS) at 24 and 48
h were assessed at rest, on coughing and on sitting up, and were not
significantly different between groups. Morphine consumption from a
patient-controlled analgesia (PCA) device was also not significantly
different between groups. Evidence of secondary hyperalgesia was assessed
with von Frey hairs 10 cm above the Pfannenstiel incision. Both groups of
patients exhibited evidence of secondary hyperalgesia after 24 and 48 h but
there were no significant differences between groups. There was also no
difference between groups in VAS scores at 1 month.
CLINICAL INVESTIGATIONS
Dextromethorphan and pain after total abdominal hysterectomy
Department of Anaesthesia, Craigavon Area Hospital, 66 Lurgan Rd, Portadown, Co. Armagh BT63 5QQ; Department of Anaesthesia, Ulster Hospital, Dundonald, Belfast BT16 0RH
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