McConaghy P M, McSorley P, McCaughey W, Campbell W I
Department of Anaesthesia, Craigavon Area Hospital, Portadown.
Br J Anaesth. 1998 Nov;81(5):731-6. doi: 10.1093/bja/81.5.731.
Dextromethorphan is an N-methyl-D-aspartate (NMDA) receptor antagonist which has been shown to inhibit the development of cutaneous secondary hyperalgesia after tissue trauma. We studied 60 ASA I-II patients undergoing total abdominal hysterectomy in a randomized, double-blind, placebo-controlled study. Patients received either dextromethorphan 27 mg capsules, two doses before operation and three doses in the first 24 h after operation, or placebo. Visual analogue pain scores (VAS) at 24 and 48 h were assessed at rest, on coughing and on sitting up, and were not significantly different between groups. Morphine consumption from a patient-controlled analgesia (PCA) device was also not significantly different between groups. Evidence of secondary hyperalgesia was assessed with von Frey hairs 10 cm above the Pfannenstiel incision. Both groups of patients exhibited evidence of secondary hyperalgesia after 24 and 48 h but there were no significant differences between groups. There was also no difference between groups in VAS scores at 1 month.
右美沙芬是一种N-甲基-D-天冬氨酸（NMDA）受体拮抗剂，已被证明可抑制组织创伤后皮肤继发性痛觉过敏的发展。我们在一项随机、双盲、安慰剂对照研究中，对60例接受全腹子宫切除术的ASA I-II级患者进行了研究。患者分别接受27毫克右美沙芬胶囊，术前两剂，术后24小时内三剂，或安慰剂。在术后24小时和48小时，对静息、咳嗽和坐起时的视觉模拟疼痛评分（VAS）进行评估，两组之间无显著差异。两组患者通过患者自控镇痛（PCA）装置使用的吗啡量也无显著差异。在耻骨联合上10厘米处用von Frey毛发评估继发性痛觉过敏的证据。两组患者在术后24小时和48小时均表现出继发性痛觉过敏的证据，但两组之间无显著差异。两组在1个月时的VAS评分也无差异。
