caa a22 4500 475803256 CHVBK 20180406123743.0 cr unu---uuuuu 170329e20000501xx s 000 0 eng 10.1007/s002689910082 doi (NATIONALLICENCE)springer-10.1007/s002689910082 Preincisional Dextromethorphan Treatment for Postoperative Pain Management after Upper Abdominal Surgery [Elektronische Daten] [Ching-Tang Wu, Jyh-Cherng Yu, Sy-Tzu Liu, Chun-Chang Yeh, Chi-Yuan Li, Chih-Shung Wong] Abstract.: Previous studies showed that ketamine, an N-methyl-d-aspartate (NMDA) receptor antagonist, provides a preemptive analgesic effect and preemptive analgesia improves postoperative pain management. The aim of this study was to examine whether premedication with dextromethorphan (DM) improves postoperative pain management after upper abdominal surgery. Sixty (American Society of Anesthesiologists class 1 and 2 of either gender) patients scheduled for upper abdominal surgery were included in the study. Patients were randomly assigned to one of four groups: control, DM-10, DM-20, and DM-40. In the control group, chlorpheniramine maleate (CPM, 20 mg) was injected immediately before induction of anesthesia intramuscularly (IM). In the DM-10, DM-20, and DM-40 groups, patients were premedicated with DM 10 mg, 20 mg, and 40 mg IM, respectively. After operation, patient-controlled analgesia (PCA) with morphine was given for pain relief. The time to the first PCA trigger, morphine consumption, pain scores, and analgesic-related side effects were recorded at 1, 2, 4, 24, 48, and 72 hours after surgery. The time to first PCA trigger for the control group was 17.8 ± 1.4 minutes, for group DM-10 20.2 ± 1.6 minutes, for group DM-20 32.4 ± 1.9 minutes, and for DM-40 77.9 ± 6.5 minutes. The morphine delivered and PCA triggering frequency were 5.5 ± 0.5/11.3 ± 0.8 times for the controls, 5.5 ± 0.4/14.1 ± 1.3 times for DM-10, 3.1 ± 0.3/6.3 ± 1.2 times for DM-20, and 0.2 ± 0.1/0.3 ± 0.2 times for DM-40 during the first hour after operation. For the first day, the figures are 19.9 ± 1.2/23.9 ± 1.4 for the controls, 15.6 ± 1.2/17.3 ± 2.4 for DM-10, 12.6 ± 0.7/15.9 ± 1.6 for DM-20, and 5.0 ± 0.21/5.6 ± 0.9 for DM-40. On the first day, the cough pain scores were 6.67 ± 0.23, 6.53 ± 0.16, 6.67 ± 0.23, and 5.73 ± 0.18 for the controls, DM-10, DM-20, and DM-40 groups, respectively. All data showed dose-dependent better pain relief in DM-premedicated patients. We conclude that DM premedication offers preemptive analgesia and reduces postoperative pain and morphine requirement. 2000 by the Société Internationale de Chir, 2000 Wu Ching-Tang Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, #8, Section 3, Tingchow Road, Taipei, Taiwan 100, Republic of China, CN aut Yu Jyh-Cherng Department of Surgery, Division of General Surgery, Tri-Service General Hospital and National Defense Medical Center, #8, Section 3, Tingchow Road, Taipei, Taiwan 100, Republic of China, CN aut Liu Sy-Tzu Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, #8, Section 3, Tingchow Road, Taipei, Taiwan 100, Republic of China, CN aut Yeh Chun-Chang Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, #8, Section 3, Tingchow Road, Taipei, Taiwan 100, Republic of China, CN aut Li Chi-Yuan Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, #8, Section 3, Tingchow Road, Taipei, Taiwan 100, Republic of China, CN aut Wong Chih-Shung Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, #8, Section 3, Tingchow Road, Taipei, Taiwan 100, Republic of China, CN aut World Journal of Surgery Springer-Verlag 24/5(2000-05-01), 512-517 0364-2313 24:5<512 2000 24 268 https://doi.org/10.1007/s002689910082 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689910082 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Wu Ching-Tang Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, #8, Section 3, Tingchow Road, Taipei, Taiwan 100, Republic of China, CN aut NATIONALLICENCE 700 1- Yu Jyh-Cherng Department of Surgery, Division of General Surgery, Tri-Service General Hospital and National Defense Medical Center, #8, Section 3, Tingchow Road, Taipei, Taiwan 100, Republic of China, CN aut NATIONALLICENCE 700 1- Liu Sy-Tzu Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, #8, Section 3, Tingchow Road, Taipei, Taiwan 100, Republic of China, CN aut NATIONALLICENCE 700 1- Yeh Chun-Chang Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, #8, Section 3, Tingchow Road, Taipei, Taiwan 100, Republic of China, CN aut NATIONALLICENCE 700 1- Li Chi-Yuan Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, #8, Section 3, Tingchow Road, Taipei, Taiwan 100, Republic of China, CN aut NATIONALLICENCE 700 1- Wong Chih-Shung Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, #8, Section 3, Tingchow Road, Taipei, Taiwan 100, Republic of China, CN aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/5(2000-05-01), 512-517 0364-2313 24:5<512 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer