Analgesic effect of intravenous ATP on postherpetic neuralgia in comparison with responses to intravenous ketamine and lidocaine.
Analgesic effect of intravenous ATP on postherpetic neuralgia in comparison with responses to intravenous ketamine and lidocaine.
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DOI：
10.1007/s00540-004-0273-1
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发表时间：
2005-01-01
影响因子：
2.8
通讯作者：
Hanaoka, Kazuo
中科院分区：
文献类型：
--
作者：
Hayashida, Masakazu;Fukuda, Ken-Ichi;Hanaoka, Kazuo
目的：尚未对 5'-三磷酸腺苷 (ATP) 对带状疱疹后神经痛 (PHN) 的镇痛作用进行研究。我们在 PHN 患者中进行了 ATP 的开放标签试验，并将 ATP 与氯胺酮和利多卡因进行比较。方法：对 12 名 PHN 患者进行了研究。隔日静脉注射氯胺酮（0.3mg.kg(-1)）、利多卡因（2mg.kg(-1)）和ATP（100μg.kg(-1).min(-1)或更少，持续120分钟）。使用视觉模拟量表（VAS）评估自发性疼痛和触觉异常性疼痛的强度。当自发性疼痛的 VAS 评分下降超过 50% 时，患者被归类为有反应者。 结果：分别有 5 名、6 名和 6 名患者对氯胺酮、利多卡因和 ATP 有反应。在 6 名 ATP 反应者中，疼痛缓解缓慢并持续 9（中位）小时（范围：3-72 小时）。所有 5 名氯胺酮应答者和 7 名氯胺酮无应答者中仅 1 名对 ATP 有应答（5/5 vs 1/7，P < 0.05，chi2 检验），而 6 名利多卡因应答者中的 2 名和 6 名利多卡因无应答者中的 4 名对 ATP 应答（2/6 vs 4/6，P > 0.05）。氯胺酮应答者对 ATP 的反应频率高于利多卡因应答者（5/5 vs 2/6，P < 0.05）。结论：静脉注射 ATP 对一半 PHN 患者发挥缓慢发展且持久的镇痛作用。患有氯胺酮反应性 PHN 的患者可能对 ATP 产生反应。
PURPOSE: No study has been performed on the analgesic effect of adenosine 5'-triphosphate (ATP) on postherpetic neuralgia (PHN). We conducted an open-label trial of ATP in patients with PHN, and compared ATP with ketamine and lidocaine.METHODS: Twelve patients with PHN were studied. On separate days, ketamine (0.3 mg.kg(-1)), lidocaine (2 mg.kg(-1)), and ATP (100 microg.kg(-1).min(-1) or less for 120 min) were administrated intravenously. The intensity of spontaneous pain as well as tactile allodynia was assessed using a visual analog scale (VAS). When the VAS score for spontaneous pain was decreased by more than 50%, the patient was classified as a responder.RESULTS: Five, 6, and 6 patients responded to ketamine, lidocaine, and ATP, respectively. In 6 ATP responders, pain relief developed slowly and lasted for 9 (median) h (range: 3-72 h). All 5 ketamine responders and only 1 of 7 ketamine nonresponders responded to ATP (5/5 vs 1/7, P < 0.05, chi2 test) whereas 2 of 6 responders to lidocaine and 4 of 6 nonresponders to lidocaine responded to ATP (2/6 vs 4/6, P > 0.05). The ketamine responders responded to ATP more often than did the lidocaine responders (5/5 vs 2/6, P < 0.05).CONCLUSION: Intravenous ATP exerted slowly developing and long-lasting analgesic effects in half of patients with PHN. Patients with ketamine-responsive PHN were likely to respond to ATP.