title: The interaction effect of perioperative cotreatment with dextromethorphan and intravenous lidocaine on pain relief and recovery of bowel function after laparoscopic cholecystectomy.
abstract: Both dextromethorphan (DM) and IV lidocaine improve postoperative pain relief. In the present study, we evaluated the interaction of DM and IV lidocaine on pain management after laparoscopic cholecystectomy (LC). One-hundred ASA physical status I or II patients scheduled for LC were randomized into four equal groups to receive either: (a) chlorpheniramine maleate (CPM) intramuscular injection (IM) 20 mg and IV normal saline (N/S) (group C); (b) DM 40 mg IM and IV N/S (group DM); (c) CPM 20 mg IM and IV lidocaine 3 mg . kg(-1) . h(-1) (group L); or (d) DM 40 mg IM and IV lidocaine (group DM+L). All treatments were administered 30 min before skin incision. Analgesic effects were evaluated using visual analog scale pain scores at rest and during coughing, time to meperidine request, total meperidine consumption, and the time to first passage of flatus after surgery. Patients of the DM+L group exhibited the best pain relief and fastest recovery of bowel function among groups. Patients in the DM and L groups had significantly better pain relief than those in the C group. The results showed an additional effect on pain relief and a synergistic effect on recovery of bowel function when DM was combined with IV lidocaine after LC.
authors.affiliation: Department of *Anesthesiology and †General Surgery, Tri-Service General Hospital; ‡Department of Public Health, National Defense Medical Center, National Defense University, Taipei; Division of §Obstetrics and Gynecology and ∥Anesthesiology, Armed Forces Taoyuan General Hospital, Taiwan, Republic of China; and ¶Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Ching-Tang
authors.initials: CT
authors.lastname: Wu
authors.forename: Cecil O
authors.initials: CO
authors.lastname: Borel
authors.forename: Meei-Shyuan
authors.initials: MS
authors.lastname: Lee
authors.forename: Jyh-Cherng
authors.initials: JC
authors.lastname: Yu
authors.forename: Hang-Seng
authors.initials: HS
authors.lastname: Liou
authors.forename: Haun-De
authors.initials: HD
authors.lastname: Yi
authors.forename: Chih-Ping
authors.initials: CP
authors.lastname: Yang
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017081:Cholecystectomy, Laparoscopic; D003915:Dextromethorphan / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004064:Digestive System / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D004357:Drug Synergism; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008614:Meperidine / Q000627:therapeutic use; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D003915:Dextromethorphan; D008012:Lidocaine; D008614:Meperidine