• Hossein Mahmoodzadeh, Ali Movafegh, and Noshin Mosavi Beigi.
• Department of Surgery, Dr. Ali Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
• Saudi J Anaesth. 2009 Jul 1; 3 (2): 57-60.

BackgroundDextromethorphan, the D-isomer of the codeine analog levorphanol, is a weak, noncompetitive N-Methyl-D-Aspartate (NMDA) receptor antagonist. It has been suggested that NMDA receptor antagonists induce preemptive analgesia when administered before tissue injury occurs, thus decreasing the subsequent sensation of pain.Materials And MethodsThe study was conducted in the Dr. Ali Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran, between February 2005 and December 2006. In this study, 72 patients scheduled for elective cholesyctectomy were randomized into three groups to receive either oral dextromethorphan 45 mg (Group D45 = 24), dextromethorphan 90 mg (Group D90 = 24), or placebo (Group C, n = 24), as premedication, 120 minutes before surgery. A visual analog scale (VAS) for pain of each patient was measured at arrival in the ward and six and 24 hours after surgery.ResultsThe demographic characteristics of patients, ASA physical status class, duration of surgery, and the basal VAS pain score were similar in the two groups. There was no significant difference in the mean of the VAS pain scores measured over time or morphine consumption among the three groups.ConclusionDextromethorphan 45 mg and 90 mg, administrated orally, two hours before surgery, had no effect on postoperative morphine requirement and pain intensity.

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