Articles: dextromethorphan-therapeutic-use.
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Randomized Controlled Trial Clinical Trial
Effect of preoperative oral dextromethorphan on immediate and late postoperative pain and hyperalgesia after total abdominal hysterectomy.
Dextromethorphan is a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist known to inhibit wind-up and NMDA-mediated nociceptive responses of dorsal horn neurons. Experimental and clinical studies indicate that NMDA-receptor antagonists may potentiate the effect of analgesics such as morphine, local anesthetics and NSAIDs. Results from previous clinical studies of dextromethorphan in postoperative pain are conflicting, possibly related to administration of insufficient doses of the drug. ⋯ There were no significant differences in side-effects (nausea, vomiting, sedation). In conclusion, oral dextromethorphan 150 mg reduced PCA morphine consumption immediately (0-4 h) after hysterectomy, without prolonged effects on pain or wound hyperalgesia. A positive correlation between the magnitude of wound hyperalgesia at 24 h after operation, and total 24 h postoperative PCA morphine consumption was demonstrated.
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Int. J. Surg. Investig. · Jan 2000
Randomized Controlled Trial Clinical TrialPostoperative intramuscular dextromethorphan injection provides pain relief and decreases opioid requirement after modified radical mastectomy.
Narcotics are still the therapeutic mainstay for postoperative pain relief. However, many unwanted side effects are accompanied. NMDA antagonists have been demonstrated to produce analgesic and antihyperalgesic effects, moreover, to possess potentiated effect of narcotics on postoperative pain management. ⋯ Postoperative DM I.M. injection provided an analgesic effect and reduced meperidine requirement after MRM.
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J Pain Symptom Manage · Jan 2000
MorphiDex (MS:DM) double-blind, multiple-dose studies in chronic pain patients.
Preclinical and double-blind single-dose placebo-controlled studies demonstrated that MorphiDex (MS:DM), a 1:1 ratio of morphine sulfate (MS) to dextromethorphan hydrobromide (DM), provides significantly greater analgesia than an equal dose of immediate release MS, with a faster onset, and a duration of > or = 8 h. The analgesic effect of MS:DM compared to MS was evaluated in 2 double-blind, multiple-dose studies in 321 patients with cancer and other chronic pain: a crossover study that consisted of two 2-wk periods and a 4-wk parallel study. As specified in the study protocols, patients took sufficient MS or MS:DM to achieve satisfactory pain control. ⋯ More patients preferred MS:DM to run-in MS than preferred MS to run-in MS (P = 0.026). The addition of DM to MS did not increase the incidence of adverse events, which were those commonly associated with opioid use. These studies confirm that MS:DM provides satisfactory pain relief but at a significantly lower morphine daily dose.
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Randomized Controlled Trial Clinical Trial
Preincisional dextromethorphan decreases postoperative pain and opioid requirement after modified radical mastectomy.
To examine whether preincisional dextromethorphan (DM) improved analgesia after modified radical mastectomy (MRM). ⋯ Preincisional IM. DM treatment decreased postoperative pain and opioid requirement after MRM surgery.