{"title":"美金刚和维生素C在术后疼痛治疗中的比较疗效：一项随机临床试验。","authors":"Masoud Saadat Fakhr, Amirhasan Mohajeri, Bahar Amini, Reza Shah Hosseini, Fatemeh Rafizadeh, Elham Esmaeili, Mahnaz Narimani Zamanabadi","doi":"10.1080/17581869.2025.2516415","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>Acute postoperative pain affects most surgical patients, often delaying recovery. Memantine (Namenda®), an N-methyl-D-aspartate (NMDA) receptor antagonist, offers potential for effective pain relief with minimal adverse effects. This study examines memantine's effectiveness in reducing acute postoperative pain and opioid consumption compared to vitamin C, which served as an active comparator.</p><p><strong>Patients and methods: </strong>This double-blind randomized clinical trial was conducted in 2021 at a single tertiary-care hospital (Boali, Amirul Mominin, and Farhikhtegan Hospital). Patients aged 15-75 undergoing elective abdominal surgery were randomized to receive either memantine (<i>n</i> = 17) or vitamin C (<i>n</i> = 17). Pain was assessed using the visual analogue scale (VAS) at 0, 6, 12, and 24 hours postoperatively, with pethidine rescue analgesia (VAS >V). Statistical analyses included the Mann-Whitney test (non-normally distributed data), repeated-measures ANOVA (time effects), and Fisher's exact test (categorical variables).</p><p><strong>Results: </strong>Memantine significantly reduced postoperative pain at all intervals compared to vitamin C (<i>p</i> < 0.05), with the largest difference at 24 hours (3.2 ± 0.2 vs. 4.7 ± 0.1, <i>p</i> < 0.001). Narcotic use was lower in the memantine group (31.7 ± 2.5 mg vs. 42.9 ± 4.1 mg, <i>p</i> = 0.81). Pain intensity declined over time in both groups, but the reduction was greater with memantine (group-by-time interaction, <i>p</i> = 0.034).</p><p><strong>Conclusions: </strong>Memantine was more effective than vitamin C (active comparator) in reducing acute postoperative pain and opioid requirements following elective abdominal surgery. These findings support memantine's potential as a non-opioid adjunct for pain management in this population. However, limitations include a small sample size, single-center design, and short follow-up period. Further multicenter trials with larger cohorts and extended observation are warranted to confirm these results and optimize dosing strategies.</p><p><strong>Clinicaltrialregistration: </strong>https://irct.behdasht.gov.ir/trial/80349 is: IRCTID: IRCT20240120060739N1).</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"379-385"},"PeriodicalIF":1.5000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12218531/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparative efficacy of memantine and vitamin C in postoperative pain management: a randomized clinical trial.\",\"authors\":\"Masoud Saadat Fakhr, Amirhasan Mohajeri, Bahar Amini, Reza Shah Hosseini, Fatemeh Rafizadeh, Elham Esmaeili, Mahnaz Narimani Zamanabadi\",\"doi\":\"10.1080/17581869.2025.2516415\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>Acute postoperative pain affects most surgical patients, often delaying recovery. Memantine (Namenda®), an N-methyl-D-aspartate (NMDA) receptor antagonist, offers potential for effective pain relief with minimal adverse effects. This study examines memantine's effectiveness in reducing acute postoperative pain and opioid consumption compared to vitamin C, which served as an active comparator.</p><p><strong>Patients and methods: </strong>This double-blind randomized clinical trial was conducted in 2021 at a single tertiary-care hospital (Boali, Amirul Mominin, and Farhikhtegan Hospital). Patients aged 15-75 undergoing elective abdominal surgery were randomized to receive either memantine (<i>n</i> = 17) or vitamin C (<i>n</i> = 17). Pain was assessed using the visual analogue scale (VAS) at 0, 6, 12, and 24 hours postoperatively, with pethidine rescue analgesia (VAS >V). Statistical analyses included the Mann-Whitney test (non-normally distributed data), repeated-measures ANOVA (time effects), and Fisher's exact test (categorical variables).</p><p><strong>Results: </strong>Memantine significantly reduced postoperative pain at all intervals compared to vitamin C (<i>p</i> < 0.05), with the largest difference at 24 hours (3.2 ± 0.2 vs. 4.7 ± 0.1, <i>p</i> < 0.001). Narcotic use was lower in the memantine group (31.7 ± 2.5 mg vs. 42.9 ± 4.1 mg, <i>p</i> = 0.81). Pain intensity declined over time in both groups, but the reduction was greater with memantine (group-by-time interaction, <i>p</i> = 0.034).</p><p><strong>Conclusions: </strong>Memantine was more effective than vitamin C (active comparator) in reducing acute postoperative pain and opioid requirements following elective abdominal surgery. These findings support memantine's potential as a non-opioid adjunct for pain management in this population. However, limitations include a small sample size, single-center design, and short follow-up period. Further multicenter trials with larger cohorts and extended observation are warranted to confirm these results and optimize dosing strategies.</p><p><strong>Clinicaltrialregistration: </strong>https://irct.behdasht.gov.ir/trial/80349 is: IRCTID: IRCT20240120060739N1).</p>\",\"PeriodicalId\":20000,\"journal\":{\"name\":\"Pain management\",\"volume\":\" \",\"pages\":\"379-385\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12218531/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pain management\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1080/17581869.2025.2516415\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/11 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pain management","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/17581869.2025.2516415","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/11 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：急性术后疼痛影响大多数手术患者，往往延迟恢复。美金刚（Namenda®）是一种n -甲基- d -天冬氨酸（NMDA）受体拮抗剂，具有潜在的有效疼痛缓解和最小的不良反应。这项研究检验了美金刚在减少急性术后疼痛和阿片类药物消耗方面的有效性，与维生素C相比，维生素C是一个有效的比较物。患者和方法：该双盲随机临床试验于2021年在一家三级医院（Boali、Amirul Mominin和Farhikhtegan医院）进行。年龄在15-75岁之间接受择期腹部手术的患者随机接受美金刚（n = 17）或维生素C （n = 17）。术后0、6、12、24小时采用视觉模拟评分法（VAS）评估疼痛，并给予哌替啶镇痛（VAS >V）。统计分析包括Mann-Whitney检验（非正态分布数据）、重复测量方差分析（时间效应）和Fisher精确检验（分类变量）。结果：与维生素C相比，美金刚能显著减轻术后疼痛（p p p = 0.81）。两组疼痛强度均随时间下降，但美金刚组疼痛强度下降更大（组间交互作用，p = 0.034）。结论：美金刚在减少选择性腹部手术后急性疼痛和阿片类药物需求方面比维生素C（活性比较物）更有效。这些发现支持美金刚作为非阿片类药物治疗疼痛的潜力。然而，该研究的局限性包括样本量小、单中心设计和随访时间短。进一步的多中心试验需要更大的队列和更广泛的观察来证实这些结果并优化给药策略。临床试验注册：https://irct.behdasht.gov.ir/trial/80349是：IRCTID: IRCT20240120060739N1)。
Comparative efficacy of memantine and vitamin C in postoperative pain management: a randomized clinical trial.
Aim: Acute postoperative pain affects most surgical patients, often delaying recovery. Memantine (Namenda®), an N-methyl-D-aspartate (NMDA) receptor antagonist, offers potential for effective pain relief with minimal adverse effects. This study examines memantine's effectiveness in reducing acute postoperative pain and opioid consumption compared to vitamin C, which served as an active comparator.
Patients and methods: This double-blind randomized clinical trial was conducted in 2021 at a single tertiary-care hospital (Boali, Amirul Mominin, and Farhikhtegan Hospital). Patients aged 15-75 undergoing elective abdominal surgery were randomized to receive either memantine (n = 17) or vitamin C (n = 17). Pain was assessed using the visual analogue scale (VAS) at 0, 6, 12, and 24 hours postoperatively, with pethidine rescue analgesia (VAS >V). Statistical analyses included the Mann-Whitney test (non-normally distributed data), repeated-measures ANOVA (time effects), and Fisher's exact test (categorical variables).
Results: Memantine significantly reduced postoperative pain at all intervals compared to vitamin C (p < 0.05), with the largest difference at 24 hours (3.2 ± 0.2 vs. 4.7 ± 0.1, p < 0.001). Narcotic use was lower in the memantine group (31.7 ± 2.5 mg vs. 42.9 ± 4.1 mg, p = 0.81). Pain intensity declined over time in both groups, but the reduction was greater with memantine (group-by-time interaction, p = 0.034).
Conclusions: Memantine was more effective than vitamin C (active comparator) in reducing acute postoperative pain and opioid requirements following elective abdominal surgery. These findings support memantine's potential as a non-opioid adjunct for pain management in this population. However, limitations include a small sample size, single-center design, and short follow-up period. Further multicenter trials with larger cohorts and extended observation are warranted to confirm these results and optimize dosing strategies.
Clinicaltrialregistration: https://irct.behdasht.gov.ir/trial/80349 is: IRCTID: IRCT20240120060739N1).
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