Improved postoperative pain control in pediatric adenotonsillectomy with dextromethorphan.
METHODS
A prospective, randomized, double-blinded, placebo-controlled protocol.


METHODS
An academic, tertiary care referral center.


METHODS
Forty randomly selected children, ages 3 to 13 years, scheduled for adenotonsillectomy without other simultaneous procedures.


METHODS
A single, oral dose of dextromethorphan pediatric cough syrup (1 mg/kg) or placebo given 30 minutes before surgery.


METHODS
Total dose requirement of intravenous morphine within a 6-hour postoperative observation period.


RESULTS
During 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.


CONCLUSIONS
Dextromethorphan 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.
Dawson
G S
GS
Department of Otolaryngology Head & Neck Surgery, West Virginia University, Morgantown, West Virginia 26506-9200, USA.
Seidman
P
P
Ramadan
H H
HH
D000233:Adenoidectomy; D000284:Administration, Oral; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003627:Data Interpretation, Statistical; D003915:Dextromethorphan / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D018691:Excitatory Amino Acid Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D009020:Morphine / Q000008:administration & dosage; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D010919:Placebos; D011446:Prospective Studies; D014068:Tonsillectomy
D018691:Excitatory Amino Acid Antagonists; D010919:Placebos; D003915:Dextromethorphan; D009020:Morphine