Rahimzadeh Poupak, Imani Farnad, Nikoubakht Nasim, Koleini Zahra, Faiz Seyed Hamid Reza, Sayarifard Azadeh
Pain Research Center, Department of Anesthesiology and Pain Medicine, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, Iran.
Center for Academic and Health Policy, Tehran University of Medical Sciences, Tehran, Iran.
Anesth Pain Med. 2017 Apr 26;7(3):e45297. doi: 10.5812/aapm.45297. eCollection 2017 Jun.
Memantine is an N-methyl-D-Aspartate (NMDA) antagonist. By transferring acute postoperative pain, the NMDA channels may lead to active excess and neuropathic pain. Objectives: This study attempted to investigate the effect of preoperative use of single oral dose of memantine in controlling Dacryocystorhinostomy (DCR) postoperative pain.
A double-blind clinical trial was conducted on 60 patients undergoing DCR. On arrival at the operating room, the memantine group received 20 mg of oral memantine and the control group received placebo. The severities of pain by visual analogue scale (VAS) and sedation by Ramsy Scale were measured immediately 1, 2, and 6 hours after the operation. The drug's side effects were recorded.
The pain scores of patients in the recovery in 1, 2, and 6 hours after operation were significantly lower in the memantine group than the placebo group (P < 0.001). The sedation score, 1 hour after the operation, was significantly greater in the memantine group than the placebo (P < 0.001). The sedation scores did not have any statistically significant difference in recovery and 2 hours after surgery between the two groups. Moreover, the sedation scores in 6 hours after the surgery were identical in the two groups.
The oral single-dose 20 mg of memantine administered before DCR can reduce postoperative pain compared with placebo.
美金刚是一种N-甲基-D-天冬氨酸（NMDA）拮抗剂。通过传递急性术后疼痛，NMDA通道可能导致活性过度和神经性疼痛。目的：本研究试图探讨术前单次口服美金刚对控制泪囊鼻腔吻合术（DCR）术后疼痛的效果。
对60例行DCR手术的患者进行双盲临床试验。到达手术室后，美金刚组口服20mg美金刚，对照组口服安慰剂。分别在术后1、2和6小时，采用视觉模拟评分法（VAS）测量疼痛程度，采用Ramsy评分法测量镇静程度。记录药物的副作用。
术后1、2和6小时，美金刚组患者恢复时的疼痛评分显著低于安慰剂组（P<0.001）。术后1小时，美金刚组的镇静评分显著高于安慰剂组（P<0.001）。两组患者术后恢复时和术后2小时的镇静评分无统计学差异。此外，两组患者术后6小时的镇静评分相同。
与安慰剂相比，DCR术前口服单剂量20mg美金刚可减轻术后疼痛。
