Iranian Red Crescent Medical Journal

Published by: Kowsar

A Comparative Study of the Effect of Oral Dextromethorphan and Placebo on the Pain After Vitrectomy Surgery: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial

Seyed Hamid Reza Faiz 1 , Nasim Nikoubakht 2 , Azadeh Sayarifard 3 and Poupak Rahimzadeh 4 , *
Authors Information
1 Rasoul-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
2 Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran
3 Community Based Participatory Research Center, Iranian Institute for Reduction of High-Risk Behaviors, Center for Academic and Health Policy, Tehran University of Medical Sciences, Tehran, Iran
4 Pain Research Center, Rasoul-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
Article information
  • Iranian Red Crescent Medical Journal: December 31, 2018, 20 (12); e64763
  • Published Online: December 19, 2018
  • Article Type: Research Article
  • Received: December 4, 2017
  • Revised: January 2, 2018
  • Accepted: January 23, 2018
  • DOI: 10.5812/ircmj.64763

To Cite: Faiz S H R, Nikoubakht N , Sayarifard A, Rahimzadeh P. A Comparative Study of the Effect of Oral Dextromethorphan and Placebo on the Pain After Vitrectomy Surgery: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial, Iran Red Crescent Med J. 2018 ; 20(12):e64763. doi: 10.5812/ircmj.64763.

Copyright © 2018, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited
1. Background
2. Objectives
3. Methods
4. Results
5. Discussion
  • 1. Fekrat S, Elsing SH, Raja SC, Campochiaro PA, de Juan EJ, Haller JA. Eye pain after vitreoretinal surgery: A prospective study of 185 patients. Retina. 2001;21(6):627-32. doi: 10.1097/00006982-200112000-00010. [PubMed: 11756886].
  • 2. Sadrolsadat SH, Yousefshahi F, Ostadalipour A, Mohammadi FZ, Makarem J. Effect of intravenous acetaminophen on postoperative pain in vitrectomy: A randomized, double-blind, clinical trial. Anesth Pain Med. 2017;7(3). e13639. doi: 10.5812/aapm.13639. [PubMed: 29181331]. [PubMed Central: PMC5696878].
  • 3. Rahimzadeh P, Imani F, Faiz SH, Nikoubakht N, Sayarifard A. Effect of intravenous methylprednisolone on pain after intertrochanteric femoral fracture surgery. J Clin Diagn Res. 2014;8(4):GC01-4. doi: 10.7860/JCDR/2014/8232.4305. [PubMed: 24959459]. [PubMed Central: PMC4064860].
  • 4. Rahimzadeh P, Imani F, Nikoubakht N, Koleini Z, Faiz SHR, Sayarifard A. A comparative study on the efficacy of oral memantine and placebo for acute postoperative pain in patients undergoing dacryocystorhinostomy (DCR). Anesth Pain Med. 2017;7(3). e45297. doi: 10.5812/aapm.45297. [PubMed: 28856113]. [PubMed Central: PMC5561447].
  • 5. Kristin N, Schonfeld CL, Bechmann M, Bengisu M, Ludwig K, Scheider A, et al. Vitreoretinal surgery: Pre-emptive analgesia. Br J Ophthalmol. 2001;85(11):1328-31. doi: 10.1136/bjo.85.11.1328. [PubMed: 11673300]. [PubMed Central: PMC1723785].
  • 6. Morgan B, Stanik-Hutt J. Utilization of a preemptive, multimodal analgesic regimen in adult ambulatory septoplasty patients: A quality improvement project. ORL Head Neck Nurs. 2015;33(4):6-13. [PubMed: 26753247].
  • 7. Vadivelu N, Mitra S, Schermer E, Kodumudi V, Kaye AD, Urman RD. Preventive analgesia for postoperative pain control: A broader concept. Local Reg Anesth. 2014;7:17-22. doi: 10.2147/LRA.S62160. [PubMed: 24872720]. [PubMed Central: PMC4012350].
  • 8. King MR, Ladha KS, Gelineau AM, Anderson TA. Perioperative dextromethorphan as an adjunct for postoperative pain: A meta-analysis of randomized controlled trials. Anesthesiology. 2016;124(3):696-705. doi: 10.1097/ALN.0000000000000950. [PubMed: 26587683]. [PubMed Central: PMC4755866].
  • 9. Suzuki M. Role of N-methyl-D-aspartate receptor antagonists in postoperative pain management. Curr Opin Anaesthesiol. 2009;22(5):618-22. doi: 10.1097/ACO.0b013e32832e7af6. [PubMed: 19535974].
  • 10. Weinbroum AA, Ben-Abraham R. Dextromethorphan and dexmedetomidine: New agents for the control of perioperative pain. Eur J Surg. 2001;167(8):563-9. doi: 10.1080/110241501753171146. [PubMed: 11716440].
  • 11. Abu-Samra MM, Ismaeil WA. Pre-emptive oral dextromethorphan reduces both postoperative and packing removal pain in patients undergoing nasal surgery. Saudi Med J. 2009;30(2):214-8. [PubMed: 19198708].
  • 12. Ali SM, Shahrbano S, Ulhaq TS. Tramadol for pain relief in children undergoing adenotonsillectomy: A comparison with dextromethorphan. Laryngoscope. 2008;118(9):1547-9. doi: 10.1097/MLG.0b013e318178272e. [PubMed: 18496149].
  • 13. Aoki T, Yamaguchi H, Naito H, Shiiki K, Ota Y, Kaneko A. Dextromethorphan premedication reduced postoperative analgesic consumption in patients after oral surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102(5):591-5. doi: 10.1016/j.tripleo.2005.10.060. [PubMed: 17052633].
  • 14. Chau-In W, Sukmuan B, Ngamsangsirisapt K, Jirarareungsak W. Efficacy of pre- and postoperative oral dextromethorphan for reduction of intra- and 24-hour postoperative morphine consumption for transabdominal hysterectomy. Pain Med. 2007;8(5):462-7. doi: 10.1111/j.1526-4637.2006.00226.x. [PubMed: 17661864].
  • 15. Lu CH, Liu JY, Lee MS, Borel CO, Yeh CC, Wong CS, et al. Preoperative cotreatment with dextromethorphan and ketorolac provides an enhancement of pain relief after laparoscopic-assisted vaginal hysterectomy. Clin J Pain. 2006;22(9):799-804. doi: 10.1097/01.ajp.0000210931.20322.da. [PubMed: 17057562].
  • 16. Weinbroum AA. Dextromethorphan reduces immediate and late postoperative analgesic requirements and improves patients' subjective scorings after epidural lidocaine and general anesthesia. Anesth Analg. 2002;94(6):1547-52. doi: 10.1097/00000539-200206000-00032. [PubMed: 12032024].
  • 17. Weinbroum AA, Bender B, Nirkin A, Chazan S, Meller I, Kollender Y. Dextromethorphan-associated epidural patient-controlled analgesia provides better pain- and analgesics-sparing effects than dextromethorphan-associated intravenous patient-controlled analgesia after bone-malignancy resection: A randomized, placebo-controlled, double-blinded study. Anesth Analg. 2004;98(3):714-22. table of contents. doi: 10.1213/01.ANE.0000100151.56901.EB. [PubMed: 14980926].
  • 18. Wu CT, Borel CO, Lee MS, Yu JC, Liou HS, Yi HD, et al. The interaction effect of perioperative cotreatment with dextromethorphan and intravenous lidocaine on pain relief and recovery of bowel function after laparoscopic cholecystectomy. Anesth Analg. 2005;100(2):448-53. doi: 10.1213/01.ANE.0000142551.92340.CC. [PubMed: 15673874].
  • 19. Yeh CC, Wu CT, Lee MS, Yu JC, Yang CP, Lu CH, et al. Analgesic effects of preincisional administration of dextromethorphan and tenoxicam following laparoscopic cholecystectomy. Acta Anaesthesiol Scand. 2004;48(8):1049-53. doi: 10.1111/j.1399-6576.2004.00455.x. [PubMed: 15315625].
  • 20. Entezary SR, Farshadpour S, Alebouyeh MR, Imani F, Emami Meybodi MK, Yaribeygi H. Effects of preoperative use of oral dextromethorphan on postoperative need for analgesics in patients with knee arthroscopy. Anesth Pain Med. 2014;4(1). e11187. doi: 10.5812/aapm.11187. [PubMed: 24660143]. [PubMed Central: PMC3961019].
  • 21. Grace RF, Power I, Umedaly H, Zammit A, Mersiades M, Cousins MJ, et al. Preoperative dextromethorphan reduces intraoperative but not postoperative morphine requirements after laparotomy. Anesth Analg. 1998;87(5):1135-8. doi: 10.1213/00000539-199811000-00029. [PubMed: 9806696].
  • 22. Ilkjaer S, Bach LF, Nielsen PA, Wernberg M, Dahl JB. Effect of preoperative oral dextromethorphan on immediate and late postoperative pain and hyperalgesia after total abdominal hysterectomy. Pain. 2000;86(1-2):19-24. doi: 10.1016/S0304-3959(99)00305-X. [PubMed: 10779656].
  • 23. Ilkjaer S, Nielsen PA, Bach LF, Wernberg M, Dahl JB. The effect of dextromethorphan, alone or in combination with ibuprofen, on postoperative pain after minor gynaecological surgery. Acta Anaesthesiol Scand. 2000;44(7):873-7. doi: 10.1034/j.1399-6576.2000.440715.x. [PubMed: 10939702].
  • 24. Mahmoodzadeh H, Movafegh A, Beigi NM. Preoperative oral dextromethorphan does not reduce pain or morphine consumption after open cholecystectomy. Saudi J Anaesth. 2009;3(2):57-60. doi: 10.4103/1658-354X.57876. [PubMed: 20532104]. [PubMed Central: PMC2876936].
  • 25. Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med. 2001;8(12):1153-7. doi: 10.1111/j.1553-2712.2001.tb01132.x. [PubMed: 11733293].
  • 26. Sessler CN, Gosnell MS, Grap MJ, Brophy GM, O'Neal PV, Keane KA, et al. The Richmond Agitation-Sedation Scale: Validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med. 2002;166(10):1338-44. doi: 10.1164/rccm.2107138. [PubMed: 12421743].
  • 27. Suski M, Bujak-Gizycka B, Madej J, Kacka K, Dobrogowski J, Woron J, et al. Co-administration of dextromethorphan and morphine: Reduction of post-operative pain and lack of influence on morphine metabolism. Basic Clin Pharmacol Toxicol. 2010;107(2):680-4. doi: 10.1111/j.1742-7843.2010.00559.x. [PubMed: 20346057].
  • 28. Henderson DJ, Withington BS, Wilson JA, Morrison LM. Perioperative dextromethorphan reduces postoperative pain after hysterectomy. Anesth Analg. 1999;89(2):399-402. [PubMed: 10439755].
  • 29. McCartney CJ, Sinha A, Katz J. A qualitative systematic review of the role of N-methyl-D-aspartate receptor antagonists in preventive analgesia. Anesth Analg. 2004;98(5):1385-400. table of contents. [PubMed: 15105220].
  • 30. Weinbroum AA, Bender B, Bickels J, Nirkin A, Marouani N, Chazam S, et al. Preoperative and postoperative dextromethorphan provides sustained reduction in postoperative pain and patient-controlled epidural analgesia requirement: A randomized, placebo-controlled, double-blind study in lower-body bone malignancy-operated patients. Cancer. 2003;97(9):2334-40. doi: 10.1002/cncr.11330. [PubMed: 12712491].
  • 31. Weinbroum AA, Rudick V, Paret G, Ben-Abraham R. The role of dextromethorphan in pain control. Can J Anaesth. 2000;47(6):585-96. doi: 10.1007/BF03018952. [PubMed: 10875724].
  • 32. Rafiei MR, Aghadavoudi O, Rezvani M, Poorqasemian M. Evaluation of preemptive analgesia with dextromethorphan gurgling in patients undergoing tonsillectomy. J Res Med Sci. 2012;17.
  • 33. Amani S, Madineh H. [The effect of oral dextrometorphan and placebo on the postoperative pain severity of adenotonsillectomy]. J Shahrekord Uuniv Med Sci. 2012;14. Persian.

Featured Image:

Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:



Create Citiation Alert
via Google Reader

Readers' Comments