A Comparative Study on the Efficacy of Oral Memantine and Placebo for Acute Postoperative Pain in Patients Undergoing Dacryocystorhinostomy (DCR)

Rahimzadeh, Poupak; Imani, Farnad; Nikoubakht, Nasim; Koleini, Zahra Sadat; Faiz, Seyed Hamid Reza; Sayarifard, Azadeh

doi:10.5812/aapm.45297

Cited by 13 publications

(20 citation statements)

References 29 publications

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“…Memantine can be used in doses starting from 5 mg to 30 mg with a gradual increase over a week, and we used 20 mg for this study as per a previous study. [ 6 ]…”

Section: Discussionmentioning

confidence: 99%

“…Rahimzadeh et al . [ 6 ] found that when memantine was administered just before induction, visual analogue scores were less at 1 h, 2 h and 6 h postoperatively in dacrocystorhinostomy, and this might have been because of the shorter duration of the procedure. In a study by Taheri et al .…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 2 ] N--methyl-D-aspartate (NMDA) receptor antagonists such as memantine have emerged in the treatment of acute post-operative pain as they have analgesic properties and excellent safety records as quoted in few studies. [ 3 4 5 6 7 ]…”

Section: Introductionmentioning

confidence: 99%

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Comparison of efficacy of gabapentin and memantine premedication in laparoscopic cholecystectomies for postoperative pain relief – A randomised placebo controlled trial

Karri

Jayaram

Kumar

et al. 2021

Indian Journal of Anaesthesia

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Background and Aims: The multiplicity of the mechanisms of the pain in laparoscopic cholecystectomy inclines us to the usage of multimodal analgesia. Gabapentin is known for its analgesic efficacy when given as premedication in many surgeries. N-methyl-D-aspartate (NMDA) antagonists are used for both acute and chronic pain, but the use of memantine in the perioperative period is less studied. The aim of this randomised controlled study was to subjectively and objectively compare postoperative pain relief using gabapentin, memantine and placebo as premedication. Methods: Sixty-six patients posted for laparoscopic cholecystectomy were randomised into three groups. During the preoperative assessment, the baseline threshold and tolerance values of pain were measured using an algesiometer. Patients were pre-medicated with oral gabapentin 600 mg or memantine 20 mg or placebo an hour before surgery. Following extubation, pain scores were reassessed (both subjectively and objectively) along with Ramsay sedation scores at different time intervals for 4 h postoperatively. Results: Gabapentin group had lower Numerical Rating Scale scores at 15 min and 1 h postoperatively when compared to the other two groups. Memantine group had a longer time for the first request for rescue analgesia (50.53 min) compared to gabapentin and placebo. The objective assessment of pain with analgesiometer showed no statistical significance between the three groups for both threshold and tolerance values. Ramsay sedation scores were higher in the gabapentin group compared to the other two. Conclusion: Gabapentin provides better postoperative pain relief compared to memantine when given as single dose premedication for laparoscopic cholecystectomy.

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“…Memantine can be used in doses starting from 5 mg to 30 mg with a gradual increase over a week, and we used 20 mg for this study as per a previous study. [ 6 ]…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of efficacy of gabapentin and memantine premedication in laparoscopic cholecystectomies for postoperative pain relief – A randomised placebo controlled trial

Karri

Jayaram

Kumar

et al. 2021

Indian Journal of Anaesthesia

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“…Many investigations have reported the effect of postoperative administration of non-opioid medications ( 22 - 25 ), including acetaminophen ( 26 - 30 ), on the postoperative pain, and opioid sparing. However, the efficacy of preoperative administration of acetaminophen on pain after surgery was reported only by limited studies ( 31 ).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Preoperative Administration of Acetaminophen and Melatonin on Retrobulbar Block Associated Pain in Cataract Surgery

et al. 2018

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BackgroundRetrobulbar block is one of the chosen methods for local anesthesia in cataract surgery. Since it is a painful procedure, using analgesic and sedative drugs is recommended. Current medications have side effects and evaluating of new drugs or new uses of existing safer drugs is necessary.ObjectivesThe aim of this study was to compare the administration of melatonin and acetaminophen on pain and hemodynamic changes during retrobulbar block.MethodsIn a double-blinded randomized trial, 180 patients undergoing cataract surgery were randomly divided into three groups: Melatonin group (received melatonin 6 mg), acetaminophen group (received acetaminophen 500 mg), and control group (received placebo). All drugs were administered orally 60 min before arrival to the operating room by nurses blinded to the drugs administered. All patients received fentanyl 0.5 μg/kg before retrobulbar block intravenously. Hemodynamic variables and pain score in each patient were evaluated on arrival in the operating room, during retrobulbar block, during surgery, 20 min after operation, at the end of surgery, and in the recovery room. In case of pain score more than three, additional fentanyl was administered. All data were recorded in structured data sheets.ResultsData analysis indicated no significant differences among the groups at baseline on any of the demographic variables. Both acetaminophen and melatonin reduced the pain score significantly compared with control during retrobulbar block (P < 0.05 and P < 0.01, respectively). Administration of additional fentanyl was significantly lower in the melatonin group than the control group (P < 0.05). Hemodynamic changes were not significantly different among all groups.ConclusionsFor the first time, as far as we have studied, the analgesic effect of acetaminophen on the retrobulbar block was indicated. We also showed that melatonin can reduce pain during retrobulbar block leading to reduction of additional fentanyl during operation. It seems that both melatonin and acetaminophen may have a beneficial effect on pain control in the retrobulbar block.

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“…However, when utilized as an adjuvant with opioids, ketamine can improve postoperative analgesia and reduce total morphine consumption in patients undergoing thoracic and abdominal surgeries (13,14). Memantine, amantadine, and dextromethorphan do not have the same extensive list of adverse side effects compared to ketamine and methadone, but they also do not show linear longterm reduction of pain (15)(16)(17).…”

Section: Nmda Antagonistsmentioning

confidence: 99%

Adjuvant Drugs for Peripheral Nerve Blocks: The Role of NMDA Antagonists, Neostigmine, Epinephrine, and Sodium Bicarbonate

et al. 2021

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: The potential for misuse, overdose, and chronic use has led researchers to look for other methods to decrease opioid consumption in patients with acute and chronic pain states. The use of peripheral nerve blocks for surgery has gained increasing popularity as it minimizes peripheral pain signals from the nociceptors of local tissue sustaining trauma and inflammation from surgery. The individualization of peripheral nerve blocks using adjuvant drugs has the potential to improve patient outcomes and reduce chronic pain. The major limitations of peripheral nerve blocks are their limited duration of action and dose-dependent adverse effects. Adjuvant drugs for peripheral nerve blocks show increasing potential as a solution for postoperative and chronic pain with their synergistic effects to increase the duration of action and decrease the required dosage of local anesthetic. N-methyl-d-aspartate (NMDA) receptor antagonists are a viable option for patients with opioid resistance and neuropathic pain due to their affinity to the neurotransmitter glutamate, which is released when patients experience a noxious stimulus. Neostigmine is a cholinesterase inhibitor that exerts its effect by competitively binding at the active site of acetylcholinesterase, which prevents the hydrolysis of acetylcholine and subsequently retaining acetylcholine at the nerve terminal. Epinephrine, also known as adrenaline, can potentially be used as an adjuvant to accelerate and prolong analgesic effects in digital nerve blocks. The theorized role of sodium bicarbonate in local anesthetic preparations is to increase the pH of the anesthetic. The resulting alkaline solution enables the anesthetic to more readily exist in its un-ionized form, which more efficiently crosses lipid membranes of peripheral nerves. However, more research is needed to show the efficacy of these adjuvants for nerve block prolongation as studies have been either mixed or have small sample sizes.

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A Comparative Study on the Efficacy of Oral Memantine and Placebo for Acute Postoperative Pain in Patients Undergoing Dacryocystorhinostomy (DCR)

Cited by 13 publications

References 29 publications

Comparison of efficacy of gabapentin and memantine premedication in laparoscopic cholecystectomies for postoperative pain relief – A randomised placebo controlled trial

Comparison of efficacy of gabapentin and memantine premedication in laparoscopic cholecystectomies for postoperative pain relief – A randomised placebo controlled trial

Efficacy of Preoperative Administration of Acetaminophen and Melatonin on Retrobulbar Block Associated Pain in Cataract Surgery

Adjuvant Drugs for Peripheral Nerve Blocks: The Role of NMDA Antagonists, Neostigmine, Epinephrine, and Sodium Bicarbonate

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