Beneficial Effect of Amantadine on Postoperative Pain Reduction and Consumption of Morphine in Patients Subjected to Elective Spine Surgery

Bujak-Giżycka, Beata; Kącka, Katarzyna; Suski, Maciej; Olszanecki, Rafał; Madej, Józef; Dobrogowski, Jan; Korbut, Ryszard

doi:10.1111/j.1526-4637.2011.01321.x

Cited by 25 publications

(8 citation statements)

References 23 publications

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“…Also, mixed results are shown in clinical trials. With few exceptions, little has been published describing the use of amantadine for its analgesic properties ( 23 , 29 , 34 ), and these publications relate to the treatment of chronic neuropathic pain rather than acute postoperative pain ( 25 , 34 , 35 ). However, the sparing effects of amantadine may have been offset in the amantadine group because of increased opioid requirements in younger versus older patients; the amantadine patients were younger than the patients in the control group ( 24 , 36 ), leading to the absence of a difference in outcome between the two groups.…”

Section: Discussionmentioning

confidence: 99%

Effect of Preoperative Oral Amantadine on Acute and Chronic Postoperative Pain After Mandibular Fracture Surgery

et al. 2016

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BackgroundPostoperative pain from open reduction and internal fixation of mandibular fracture is a serious issue. Amantadine is an N-methyl-D-aspartic acid or N-methyl-D-aspartate (NMDA) receptor antagonist that can be effective against postoperative pain.ObjectivesThe present study examined the efficacy of amantadine in alleviating the postoperative pain of mandibular fracture surgery.Patients and MethodsIn this double-blind study, 60 patients (ASA physical status I–II) were randomly divided into two groups. The mean ages of the participants were 31.2 ± 13.1 years and 32.3 ± 18.1 years, respectively. The male/female ratios were 24/6 and 26/4, respectively, in the case and control groups. Randomization was based on a single sequence of random assignments using computer-generated random numbers. Group I was given oral amantadine 100 mg 1 hour before surgery, and group II received a placebo at the identical time. Through PCA pumps, patients received a bolus dose of morphine at 0.02 mg/kg body weight, to a maximum of 1.5 mg. PCA pumps were set at 6 minutes lockout intervals and a maximum dose of 0.15 mg/kg/h, to a maximum of 10 mg/h. Pain was assessed using a visual analog scale (VAS) at 0, 2, 4, 6, 12, and 24 hours and 1, 2, 3, 4, 5, and 6 months after surgery. The amounts of analgesic consumed were recorded for the first 24 hours, and for 6 months after surgery.ResultsThere were no significant differences between the two groups with respect to age, gender, nausea and vomiting, sleep quality, blood pressure, and heart rate. No significant differences were observed between the two groups in pain scores (P = 0.39) and analgesic consumption (P = 0.78).ConclusionsThe results suggest that a single dose of preoperative oral amantadine did not reduce acute or chronic postoperative pain, nor analgesic consumption.

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Section: Discussionmentioning

confidence: 99%

Effect of Preoperative Oral Amantadine on Acute and Chronic Postoperative Pain After Mandibular Fracture Surgery

et al. 2016

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“…One RCT evaluated the use of amantadine for perioperative pain management in patients undergoing thoracolumbar fusion for correction of idiopathic scoliosis. 21 Amantadine is an antiparkinsonian medication with an unclear mechanism of action. It is thought to modulate dopaminergic and noradrenergic release and to act as a weak NMDA (N-methyl-D-aspartate) antagonist.…”

Section: Neuromodulatory Agentsmentioning

confidence: 99%

“…Patients who were randomized to receive either 50 mg or 100 mg of amantadine 1 hour before surgery and at specified intervals postoperatively reported reduced pain, required 25% less morphine, and had reduced opioid-induced nausea up to 48 hours postoperatively, compared with patients who received a placebo. 21 This single RCT represents level I evidence to support the use of amantadine for perioperative spine analgesia (Table 2). However, this agent should be further studied and its adverse effect profile better defined.…”

Section: Neuromodulatory Agentsmentioning

confidence: 99%

The Role of Multimodal Analgesia in Spine Surgery

Kurd

Kreitz

Schroeder

et al. 2017

J Am Acad Orthop Surg

142

107

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Optimal postoperative pain control allows for faster recovery, reduced complications, and improved patient satisfaction. Historically, pain management after spine surgery relied heavily on opioid medications. Multimodal regimens were developed to reduce opioid consumption and associated adverse effects. Multimodal approaches used in orthopaedic surgery of the lower extremity, especially joint arthroplasty, have been well described and studies have shown reduced opioid consumption, improved pain and function, and decreased length of stay. A growing body of evidence supports multimodal analgesia in spine surgery. Methods include the use of preemptive analgesia, NSAIDs, the neuromodulatory agents gabapentin and pregabalin, acetaminophen, and extended-action local anesthesia. The development of a standard approach to multimodal analgesia in spine surgery requires extensive assessment of the literature. Because a substantial number of spine surgeries are performed annually, a standardized approach to multimodal analgesia may provide considerable benefits, particularly in the context of the increased emphasis on accountability within the healthcare system.

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“…En resumen, los beneficios clínicos de la amantadina adyuvante siguen siendo ambiguos. Las posibles explicaciones de los resultados contradictorios encontrados en la literatura incluyen el modo de administración (oral 50-200 mg/día versus 200 mg vía intravenosa), el régimen de dosificación (dosis única frente a la repetida), así como la naturaleza del procedimiento quirúrgico (33)(34)(35).…”

Section: Otros Coadyuvantesunclassified

Coadyuvantes farmacológicos con efecto ahorrador de opioides en el periodo perioperatorio

Bujedo

Santos

Uría-Azpiazu

et al. 2018

Rev. Soc. Esp. Dolor.

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Beneficial Effect of Amantadine on Postoperative Pain Reduction and Consumption of Morphine in Patients Subjected to Elective Spine Surgery

Abstract: Pre- and postoperative administration of amantadine significantly reduced fentanyl use during operation, as well as reduced the postoperative pain and decreased morphine consumption in young patients undergoing orthopedic surgery.

Cited by 25 publications

References 23 publications

Effect of Preoperative Oral Amantadine on Acute and Chronic Postoperative Pain After Mandibular Fracture Surgery

Effect of Preoperative Oral Amantadine on Acute and Chronic Postoperative Pain After Mandibular Fracture Surgery

The Role of Multimodal Analgesia in Spine Surgery

Coadyuvantes farmacológicos con efecto ahorrador de opioides en el periodo perioperatorio

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