The Efficacy of Morphine, Pregabalin, Gabapentin, and Duloxetine on Mechanical Allodynia Is Different from That on Neuroma Pain in the Rat Neuropathic Pain Model
The Efficacy of Morphine, Pregabalin, Gabapentin, and Duloxetine on Mechanical Allodynia Is Different from That on Neuroma Pain in the Rat Neuropathic Pain Model
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DOI：
10.1213/ane.0b013e31824f94ca
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发表时间：
2012-07-01
影响因子：
5.7
通讯作者：
Yamamoto, Tatsuo
中科院分区：
文献类型：
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作者：
Miyazaki, Rika;Yamamoto, Tatsuo
背景：据报道，不到50%的神经病理性疼痛患者通过药物治疗获得满意的疗效。这种对神经性疼痛缺乏疗效的药物可能是由于处方的药物，而不管疼痛的起源。我们比较了口服吗啡，普瑞巴林，加巴喷丁，度洛沙丁胺醇对机械性异常性疼痛与神经瘤疼痛使用胫神经瘤转位（TNT）model.METHODS：在TNT模型中，胫神经被切断，胫神经残端被转位到后肢的外侧。TNT损伤后，观察到机械性异常性疼痛和神经瘤疼痛。吗啡，普瑞巴林，加巴喷丁，度洛沙丁胺醇口服给药，并进行了检查的antiallodynic和antineuroma pain effects.RESULTS：吗啡，普瑞巴林，加巴喷丁，度洛沙丁胺醇衰减的机械性异常性疼痛的水平在剂量依赖性的方式。吗啡，而不是普瑞巴林，加巴喷丁，度洛西汀，减轻神经瘤疼痛。吗啡对神经瘤疼痛的作用不如对机械性异常性疼痛的作用强。在2种药物联合研究中（吗啡+普瑞巴林、吗啡+度洛沙汀和普瑞巴林+度洛沙汀），所有药物组合对机械性异常性疼痛产生协同作用，但对神经瘤疼痛不产生协同作用。这些数据表明，吗啡的效力和普瑞巴林、加巴喷丁，和度洛西汀对机械性异常性疼痛的作用不同于对神经瘤疼痛的作用，联合治疗是治疗神经病理性疼痛的不同治疗选择之一。（Anesth Analg 2012;115：182-8）
BACKGROUND: It has been reported that < 50% of neuropathic pain patients are satisfactorily treated with drugs. It is possible that this lack of efficacy of drugs on neuropathic pain might be due to the drugs prescribed, regardless of the origin of pain. We compared the efficacy of orally administered morphine, pregabalin, gabapentin, and duloxetine on mechanical allodynia with that on neuroma pain using the tibial neuroma transposition (TNT) model.METHODS: In the TNT model, the tibial nerve is transected, and the tibial nerve stump is transpositioned to the lateral aspect of the hindlimb. After TNT injury, mechanical allodynia and neuroma pain are observed. Morphine, pregabalin, gabapentin, and duloxetine were administered orally and were examined for the antiallodynic and antineuroma pain effects.RESULTS: Morphine, pregabalin, gabapentin, and duloxetine attenuated the level of mechanical allodynia in a dose-dependent manner. Morphine-but not pregabalin, gabapentin, and duloxetine-attenuated the neuroma pain. Morphine was less potent in neuroma pain than in mechanical allodynia. In the 2-drug-combination studies (morphine + pregabalin, morphine + duloxetine, and pregabalin + duloxetine), all drug combinations produced a synergistic effect on mechanical allodynia, but not on neuroma pain.CONCLUSIONS: These data indicate that the potency of morphine and the efficacy of pregabalin, gabapentin, and duloxetine on mechanical allodynia are different from those on neuroma pain and that combination therapy is one of different therapeutic choices for the treatment of neuropathic pain. (Anesth Analg 2012;115:182-8)