Differential effect of intravenous S-ketamine and fentanyl on atypical odontalgia and capsaicin-evoked pain
Differential effect of intravenous S-ketamine and fentanyl on atypical odontalgia and capsaicin-evoked pain
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DOI：
10.1016/j.pain.2006.09.032
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发表时间：
2007-05-01
期刊：
影响因子：
7.4
通讯作者：
Svensson, Peter
中科院分区：
文献类型：
--
作者：
Baad-Hansen, Lene;Juhl, Gitte Irene;Svensson, Peter
非典型牙痛（AO）是一种目前机制未知的口腔内疼痛。在 10 名 AO 患者和 10 名匹配的健康对照中，我们检查了静脉输注 N-甲基-D-天冬氨酸 (NMDA) 受体拮抗剂 S-氯胺酮和 mu-阿片激动剂芬太尼对自发性 AO 疼痛和局部应用辣椒素引起的急性口腔内伤害性输入的影响。这些药物以随机、安慰剂对照、交叉的方式给药。此外，还比较了组间和两侧之间对机械和热定量感觉测试（QST）的口内敏感性测量，包括时间总和。这两种药物均未能对自发性 AO 疼痛产生镇痛作用，但芬太尼可有效减轻辣椒素引起的疼痛。 AO患者对辣椒素和热痛的敏感性增加，但与健康对照相比，冷和机械敏感性没有显着差异。 AO 患者的 QST 测量值没有发现左右差异。目前的研究表明，AO 不太可能主要是由于来自周围区域的持续性传入屏障造成的。此外，与对各种神经性疼痛状况的研究相比，目前剂量的芬太尼和 S-氯胺酮未能减轻 AO 疼痛。 (c) 2006 年国际疼痛研究协会。由 Elsevier B.V. 出版。保留所有权利。
Atypical odontalgia (AO) is an intraoral pain condition of currently unknown mechanisms. In 10 AO patients and 10 matched healthy controls, we examined the effect of intravenous infusion of an N-methyl-D-aspartate (NMDA) receptor antagonist S-ketamine and a mu-opioid agonist fentanyl on spontaneous AO pain and on an acute intraoral nociceptive input evoked by topical application of capsaicin. The drugs were administered in a randomized, placebo-controlled, cross-over manner. Furthermore, measures of intraoral sensitivity to mechanical and thermal quantitative sensory testing (QST) including temporal summation were compared between groups and sides. Both drugs failed to produce an analgesic effect on spontaneous AO pain, but fentanyl effectively reduced capsaicin-evoked pain. AO patients showed increased sensitivity to capsaicin and heat pain, but no significant differences in cold and mechanical sensitivity compared with healthy controls. No side-to-side differences in QST measures were found in AO patients. The present study demonstrates that AO is unlikely to be primarily due to a persistent afferent barrage from the peripheral region. Furthermore, in contrast to studies on various neuropathic pain conditions, fentanyl and S-ketamine in the present doses failed to attenuate AO pain. (c) 2006 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.