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Dextromethorphan is a weak, noncompetitive NMDA antagonist that has been used as an
antitussive agent. It has been shown to inhibit development of cutaneous secondary
hyperalgesia in people after peripheral burn injury and to reduce temporal summation of
pain40. Several studies investigated the effect of the perioperative administration ofdextromethorphan on acute postoperative pain. Opiate-related adverse effects were similar
between patients who received dextromethorphan and control patients. Postoperative
administration of IM dextromethorphan at a dose of 40 mg and oral dextromethorphan (200
mg every 8 hours) also were associated with a significant reduction in postoperative opioid
consumption41
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