Perioperative Medizin最新文献

{"title":"Effects of dextromethorphan on postoperative pain after orthopedic surgery under spinal anesthesia","authors":"Andreas Hohn ,&nbsp;Nikola Magheli ,&nbsp;Hartmut Bürkle ,&nbsp;Jeannette Horn ,&nbsp;Stefan Soltesz ,&nbsp;Frank Wappler","doi":"10.1016/j.periop.2010.03.005","DOIUrl":"10.1016/j.periop.2010.03.005","url":null,"abstract":"<div><h3>Purpose</h3><p><span>Previous studies showed that pre-incisional administration of dextromethorphan<span><span> (DM), a weak N-methyl-D-aspartic (NMDA) acid antagonist, reduces postoperative pain after epidural as well as </span>general anesthesia. Aim of this study was therefore to proof the effects of DM on postoperative pain </span></span>in patients<span> undergoing orthopedic surgery under spinal anesthesia.</span></p></div><div><h3>Methods</h3><p>Forty-five patients undergoing elective orthopedic surgery were enrolled in this prospective, double-blinded and randomized study. Patients were randomly assigned to three groups (n<!--> <!-->=<!--> <!-->15) and received either placebo or dextromethorphan (45 or 90<!--> <span>mg) p.o. Afterwards, a spinal catheter was inserted at the L2/3 or L3/4 interspace and spinal anesthesia with bupivacaine<span> was induced and maintained at a level between Th 10 and Th 12. After completion of surgery patient controlled analgesia<span><span> (PCA) with piritramide was started. Visual analogue pain scales (VAS) and </span>analgesic requirements were assessed before surgery (control) as well as during the first 48</span></span></span> <!-->hours.</p></div><div><h3>Results</h3><p><span>The three groups were comparable with respect to biometric data, distribution of surgery as well as preoperative pain levels. VAS scores were not different between the three groups within 48</span> <!-->hours postoperatively. Furthermore, administration of pre-incisional DM had no influence on postoperative requirements of opioids (group D90: 59.5<!--> <!-->±<!--> <!-->37.5<!--> <!-->mg; group D45: 56.2<!--> <!-->±<!--> <!-->37.1<!--> <!-->mg piritramide; and group P: 49.3<!--> <!-->±<!--> <!-->29.2<!--> <!-->mg piritramide) within 48<!--> <!-->hours.</p></div><div><h3>Conclusions</h3><p>In this study DM enables neither reduction of postoperative pain intensity nor analgesic- or opioid-sparing effects. Further studies to find out ideal dosage, way of administration and applicable kind of surgery should be implemented.</p></div><div><h3>Hintergrund</h3><p>Zahlreiche Untersuchungen konnten die analgetische Wirksamkeit des NMDA-Rezeptor-Antagonisten Dextromethorphan (DM) bei präoperativer Verabreichung bei Eingriffen sowohl in Allgemeinanästhesie, als auch unter Epiduralanästhesie zeigen. Ziel dieser Studie war es, die analgetischen Effekte von DM bei orthopädischen Eingriffen in Spinalanästhesie zu überprüfen.</p></div><div><h3>Methoden</h3><p>In diese prospektive, randomisierte, doppelblinde Studie wurden 45 Patienten vor einem orthopädischen Gelenkersatz der Hüfte oder des Knies eingeschlossen. Die Patienten wurden in drei gleich große Gruppen (n<!--> <!-->=<!--> <!-->15) randomisiert und erhielten neben der oralen Prämedikation (Midazolam 7,5<!--> <!-->mg) ebenfalls oral entweder Placebo oder 45 bzw. 90<!--> <!-->mg Dextromethorphan. Die Spinalanästhesie mit Bupivacain wurde in Kathetertechnik durchgeführt und über Nachi","PeriodicalId":101007,"journal":{"name":"Perioperative Medizin","volume":"2 3","pages":"Pages 117-124"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.periop.2010.03.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75692253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}