title: Dextromethorphan premedication reduced postoperative analgesic consumption in patients after oral surgery.
abstract: OBJECTIVE
  N-methyl-D-aspartate (NMDA) receptor antagonist premedication reduces postoperative pain. In this study, we examined if NMDA antagonist premedication might reduce postoperative pain after oral surgery, testing dextromethorphen.
  
  
  METHODS
  One hundred eleven patients undergoing mandibular third molar extraction under local anesthesia were included. Patients were randomly allocated into 3 groups. Group A (n = 37), B (n = 38), and C (n = 36) patients were emphasis-placed on dextromethorphan 30 mg, diclofenac 25 mg, or placebo orally before surgery, respectively. Postoperatively, patients were allowed to use oral diclofenac, 25 mg, for postoperative pain relief. Postoperative pain was evaluated the 1st, 7th, and 14th day after surgery, respectively, by using a visual analog scale (VAS) and the number of diclofenac consumed. VAS score and the number of diclofenac consumption were compared among the groups.
  
  
  RESULTS
  VAS score was similar among the 3 groups during the study period. Total postoperative diclofenac consumption was significantly less in group A than in group C (P < 0.05).
  
  
  CONCLUSIONS
  Dextromethorphan premedication reduced postoperative analgesic consumption after oral surgery.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Tokai University School of Medicine, Isehara, Japan. taoki123jp@ybb.ne.jp <taoki123jp@ybb.ne.jp>
authors.forename: Takayuki
authors.initials: T
authors.lastname: Aoki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamaguchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Naito
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shiiki
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Ota
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kaneko
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000704:Analysis of Variance; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D019540:Area Under Curve; D003915:Dextromethorphan / Q000008:administration & dosage*; D004008:Diclofenac / Q000008:administration & dosage; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible; D008964:Molar, Third / Q000601:surgery; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D011292:Premedication; D011446:Prospective Studies; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors; D018709:Statistics, Nonparametric; D014081:Tooth Extraction
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D016194:Receptors, N-Methyl-D-Aspartate; D004008:Diclofenac; D003915:Dextromethorphan