title: Preoperative oral dextromethorphan attenuated tourniquet-induced arterial blood pressure and heart rate increases in knee cruciate ligament reconstruction patients under general anesthesia.
abstract: The precise mechanism of tourniquet-induced arterial blood pressure increase is unknown. We determined the effect of preoperative oral dextromethorphan (DM) on arterial blood pressure and heart rate changes during tourniquet inflation in knee cruciate ligament reconstruction patients under general anesthesia. Patients in the DM group (n = 38) received oral DM 30 mg, and patients in the control group (n = 38) received oral placebo 2 h before the induction of anesthesia. Anesthesia was maintained with sevoflurane 2.0% and N(2)O in 33% oxygen, and the trachea was intubated until the end of surgery. Arterial blood pressure and heart rate were measured at 0, 30, and 60 min after the start of tourniquet inflation. Systolic arterial blood pressure and heart rate at 60 min in the control group were significantly more than those in the DM group (131.1 +/- 15.8 mm Hg versus 123.6 +/- 15.9 mm Hg [P < 0.05] and 74.1 +/- 11.3 bpm versus 67.8 +/- 8.5 bpm [P < 0.01], respectively). The percentage increase in systolic arterial blood pressure and heart rate in the DM group was also attenuated when compared with that in the control group (P < 0.05). In conclusion, preoperative oral DM 30 mg significantly attenuated arterial blood pressure and heart rate increases during tourniquet inflation under general anesthesia.
  
  
  CONCLUSIONS
  We demonstrated that preoperative oral dextromethorphan 30 mg significantly attenuated arterial blood pressure and heart rate increases at 60 min during tourniquet inflation in patients undergoing knee cruciate ligament reconstruction under general anesthesia.
authors.affiliation: Departments of *Anesthesia and Critical Care Medicine and ‡Orthopedics, Iwaki Kyoritsu General Hospital, Iwaki, Fukushima, Japan; and †Department of Anesthesia, Ryugasaki Saiseikai Hospital, Ryugasaki, Ibaraki, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Yamashita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamaguchi
authors.forename: Yu
authors.initials: Y
authors.lastname: Hisajima
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ijima
authors.forename: Kaori
authors.initials: K
authors.lastname: Saito
authors.forename: Ai
authors.initials: A
authors.lastname: Chiba
authors.forename: Toru
authors.initials: T
authors.lastname: Yasunaga
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001794:Blood Pressure / Q000187:drug effects*; D003915:Dextromethorphan / Q000627:therapeutic use*; D004311:Double-Blind Method; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use*; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D008297:Male; D016119:Posterior Cruciate Ligament / Q000601:surgery*; D011446:Prospective Studies; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors; D014111:Tourniquets / Q000009:adverse effects*
chemical_list: D018691:Excitatory Amino Acid Antagonists; D016194:Receptors, N-Methyl-D-Aspartate; D003915:Dextromethorphan