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2016 ; 2016
(ä): 1658172
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Effect of N-Methyl-D-Aspartate Receptor Antagonist Dextromethorphan on Opioid
Analgesia in Pediatric Intensive Care Unit
#MMPMID27867308
Naeem M
; Al Alem H
; Al Shehri A
; Al-Jeraisy M
Pain Res Manag
2016[]; 2016
(ä): 1658172
PMID27867308
show ga
Objective. Pain control is an essential goal in the management of critical
children. Narcotics are the mainstay for pain control. Patients frequently need
escalating doses of narcotics. In such cases an adjunctive therapy may be
beneficial. Dextromethorphan (DM) is NMDA receptor antagonist and may prevent
tolerance to narcotics; however, its definitive role is still unclear. We sought
whether dextromethorphan addition could decrease the requirements of fentanyl to
control pain in critical children. Design. Double-blind, randomized control trial
(RCT). Setting. Pediatric multidisciplinary ICU in tertiary care center.
Patients. Thirty-six pediatric patients 2-14 years of age in a multidisciplinary
PICU requiring analgesia were randomized into dextromethorphan and placebo. The
subjects in both groups showed similarity in most of the characteristics.
Interventions. Subjects while receiving fentanyl for pain control received
dextromethorphan or placebo through nasogastric/orogastric tubes for 96 hours.
Pain was assessed using FLACC and faces scales. Measurements and Main Results.
This study found no statistical significant difference in fentanyl requirements
between subjects receiving dextromethorphan and those receiving placebo (p =
0.127). Conclusions. Dextromethorphan has no effect on opioid requirement for
control of acute pain in children admitted with acute critical care illness in
PICU. The registration number for this trial is NCT01553435.
|Adolescent
[MESH]
|Analgesics, Opioid/*therapeutic use
[MESH]
|Child
[MESH]
|Child, Preschool
[MESH]
|Dextromethorphan/*therapeutic use
[MESH]
|Double-Blind Method
[MESH]
|Excitatory Amino Acid Antagonists/*therapeutic use
[MESH]