• G S Dawson, P Seidman, and H H Ramadan.
• Department of Otolaryngology Head & Neck Surgery, West Virginia University, Morgantown, West Virginia 26506-9200, USA.
• Laryngoscope. 2001 Jul 1;111(7):1223-6.

DesignA prospective, randomized, double-blinded, placebo-controlled protocol.SettingAn academic, tertiary care referral center.PatientsForty randomly selected children, ages 3 to 13 years, scheduled for adenotonsillectomy without other simultaneous procedures.InterventionA single, oral dose of dextromethorphan pediatric cough syrup (1 mg/kg) or placebo given 30 minutes before surgery.Main Outcome MeasureTotal dose requirement of intravenous morphine within a 6-hour postoperative observation period.ResultsDuring routine postoperative observation, significantly fewer patients in the dextromethorphan group required no intravenous morphine compared with the placebo group (P =.03). Of those children requiring morphine, the mean dose requirement was significantly lower in the dextromethorphan group (P =.02). There was no known drug-related morbidity.ConclusionDextromethorphan syrup is a safe, non-narcotic medication that significantly reduced the requirement of intravenous morphine after pediatric adenotonsillectomy. Its routine use in this manner is recommended.

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