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Anesth Analg 2007;104:1251-1255
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000260330.18745.a8

PAIN MECHANISMS

Dextromethorphan or Dextrorphan Have a Local Anesthetic Effect on Infiltrative Cutaneous Analgesia in Rats

Yu-Wen Chen, PhD*, Koung-Shing Chu, MD*, Ching-Nan Lin, MD*, Jann-Inn Tzeng, MD, MS*, Chin-Chen Chu, MD*, Mao-Tsun Lin, PhD*, and Jhi-Joung Wang, MD, PhD*

From the *Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan; and {dagger}Department of Anesthesiology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan.

Address correspondence and reprint requests to Dr. Jhi-Joung Wang, MD, PhD, Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan. Address e-mail to 400002{at}mail.chimei.org.tw.

Abstract

BACKGROUND: Dextromethorphan blocks sodium channels, the site of action of local anesthetics. In this study we evaluated whether dextromethorphan has a local anesthetic effect.

METHODS: We administered dextromethorphan and its active metabolite— dextrorphan, and lidocaine subcutaneously to rats and tested them for cutaneous anesthesia. Drug–drug interactions and systemic safety indices (LD50s/ED50s) were also evaluated.

RESULTS: Dextromethorphan and dextrorphan had a local anesthetic effect after cutaneous infiltration. The ranking of potencies was dextromethorphan > dextrorphan > lidocaine (P < 0.01 for each comparison). A combination of dextromethorphan or dextrorphan with lidocaine produced an additive effect. Dextromethorphan and dextrorphan had 2.4- and 1.9-fold higher system safety indices than did lidocaine.

CONCLUSION: Dextromethorphan and dextrorphan were more potent local anesthetics than lidocaine, but with higher systemic safety indices. Coadministration of dextromethorphan or dextrorphan with lidocaine produced an additive effect.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2007 by the International Anesthesia Research Society.