Pain, Postoperative Clinical Trial
Official title:
A Prospective Randomized Double-blind Placebo Controlled Trial; Does Pre and Postoperative Dextromethorphan Reduce Post-tonsillectomy Pain in Children?
With Institutional ethics board and Health Canada approval, pediatric patients (ages 3-12) undergoing tonsillectomy or adenotonsillectomy (under standardized anesthesia) will be randomized to receive dextromethorphan hydrobromide (1mg/kg orally) 30 min preoperatively and again 8 hours postoperatively OR placebo (syrup identical in taste, appearance and volume) at the same time points. The primary outcome is an integrated assessment of perioperative pain scores and opioid use for 24 hours postoperatively. Secondary outcomes include nausea, vomiting, respiratory depression, and bleeding for 24 hours postoperatively. Our hypothesis is that dextromethorphan will decrease the incidence/severity of post-tonsillectomy pain. The improved pain control will be apparent through reduced opioid consumption and integrated pain scores. This will result in a reduced incidence of opioid-related side effects and adverse events.
With Institutional ethics board and Health Canada approval and parental consent and child
assent, pediatric patients (ages 3-12) undergoing tonsillectomy or adenotonsillectomy (under
standardized anesthesia) will be randomized to receive dextromethorphan hydrobromide (1mg/kg
orally) 30 min preoperatively and again 8 hours postoperatively OR placebo (syrup identical
in taste, appearance and volume) at the same time points. The primary outcome is an
integrated assessment of perioperative pain scores and opioid use for 24 hours
postoperatively. Pain scores were collected preoperatively at rest and then at 1,2,3,8,9,10
and 24 hours postoperatively using the validated Children's Hospital of Eastern Ontario Pain
Scale (CHEOPS). Secondary outcomes include nausea, vomiting, respiratory depression, and
bleeding recorded by blinded observers for 24 hours postoperatively.
Our hypothesis is that dextromethorphan will decrease the incidence/severity of
post-tonsillectomy pain. The improved pain control will be apparent through reduced opioid
consumption and integrated pain scores. This will result in a reduced incidence of
opioid-related side effects and adverse events.
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