Effect of N-Methyl-D-Aspartate Receptor Antagonist Dextromethorphan on Opioid Analgesia in Pediatric Intensive Care Unit
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 p...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Pain Research and Management |
| Online Access: | http://dx.doi.org/10.1155/2016/1658172 |
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| _version_ | 1832558602622074880 |
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| author | Mohammed Naeem Hala Al Alem Ali Al Shehri Majed Al-Jeraisy |
| author_facet | Mohammed Naeem Hala Al Alem Ali Al Shehri Majed Al-Jeraisy |
| author_sort | Mohammed Naeem |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-8050e16f72194ac38010498f4f4f7b6e |
| institution | Kabale University |
| issn | 1203-6765 1918-1523 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pain Research and Management |
| spelling | doaj-art-8050e16f72194ac38010498f4f4f7b6e2025-02-03T01:31:58ZengWileyPain Research and Management1203-67651918-15232016-01-01201610.1155/2016/16581721658172Effect of N-Methyl-D-Aspartate Receptor Antagonist Dextromethorphan on Opioid Analgesia in Pediatric Intensive Care UnitMohammed Naeem0Hala Al Alem1Ali Al Shehri2Majed Al-Jeraisy3Department of Pediatrics, Division PICU, King Abdulaziz Medical City, Riyadh, Saudi ArabiaDepartment of Pediatrics, Division PICU, King Abdulaziz Medical City, Riyadh, Saudi ArabiaDepartment of Pediatrics, Division PICU, King Abdulaziz Medical City, Riyadh, Saudi ArabiaKing Saud Bin Abdulaziz University-Health Sciences (KSAU-HS), Riyadh, Saudi ArabiaObjective. 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.http://dx.doi.org/10.1155/2016/1658172 |
| spellingShingle | Mohammed Naeem Hala Al Alem Ali Al Shehri Majed Al-Jeraisy Effect of N-Methyl-D-Aspartate Receptor Antagonist Dextromethorphan on Opioid Analgesia in Pediatric Intensive Care Unit Pain Research and Management |
| title | Effect of N-Methyl-D-Aspartate Receptor Antagonist Dextromethorphan on Opioid Analgesia in Pediatric Intensive Care Unit |
| title_full | Effect of N-Methyl-D-Aspartate Receptor Antagonist Dextromethorphan on Opioid Analgesia in Pediatric Intensive Care Unit |
| title_fullStr | Effect of N-Methyl-D-Aspartate Receptor Antagonist Dextromethorphan on Opioid Analgesia in Pediatric Intensive Care Unit |
| title_full_unstemmed | Effect of N-Methyl-D-Aspartate Receptor Antagonist Dextromethorphan on Opioid Analgesia in Pediatric Intensive Care Unit |
| title_short | Effect of N-Methyl-D-Aspartate Receptor Antagonist Dextromethorphan on Opioid Analgesia in Pediatric Intensive Care Unit |
| title_sort | effect of n methyl d aspartate receptor antagonist dextromethorphan on opioid analgesia in pediatric intensive care unit |
| url | http://dx.doi.org/10.1155/2016/1658172 |
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