NMDA receptor blockade in chronic neuropathic pain: A comparison of ketamine and magnesium chloride
NMDA receptor blockade in chronic neuropathic pain: A comparison of ketamine and magnesium chloride
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DOI：
10.1016/0304-3959(95)00113-1
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发表时间：
1996-02-01
期刊：
影响因子：
7.4
通讯作者：
Jensen, TS
中科院分区：
文献类型：
--
作者：
Felsby, S;Nielsen, J;Jensen, TS
十个病人（4名女性，6名男性），年龄34-67岁，患有周围神经性疼痛，参加了一项双盲安慰剂对照研究，其中通过10分钟推注给予氯胺酮或氯化镁（氯胺酮：0.84 μ mol/kg = 0.2 mg/kg，镁：0.16 mmol/kg），随后连续输注（氯胺酮：1.3 μ mol/kg/h = 0.3 mg/kg/h，镁：0.16 mmol/kg/h）。在药物输注前和输注过程中，通过VAS评分、触摸诱发的异常性疼痛面积、机械和热刺激的检测和疼痛阈值确定持续疼痛。氯胺酮可显著减少自发性疼痛（57%）和异常性疼痛面积（33%）。氯化镁减少疼痛（29%）和面积异常性疼痛（18%）不显着。氯胺酮后，持续疼痛的减少与触摸诱发的异常性疼痛面积的减少之间存在显著相关性。对机械和热刺激的检测和痛阈没有显著改变。这些发现表明，神经性疼痛中的持续性疼痛和触摸诱发的疼痛（异常性疼痛）是相互关联的现象，可能由相同的机制介导，并涉及N-甲基-D-天冬氨酸受体。
Ten patients (4 female, 6 male) aged 34-67 years suffering from peripheral neuropathic pain participated in a double-blind placebo-controlled study where ketamine or magnesium chloride were administered by a 10 min bolus infusion (ketamine: 0.84 mu mol/kg = 0.2 mg/kg, magnesium: 0.16 mmol/kg) followed by a continuous infusion (ketamine: 1.3 mu mol/kg/h = 0.3 mg/kg/h, magnesium: 0.16 mmol/kg/h). Ongoing pain determined by VAS score, area of touch-evoked allodynia, detection and pain thresholds to mechanical and thermal stimuli were measured before and during drug infusion, Ketamine produced a significant reduction of spontaneous pain (57%) and of the area of allodynia (33%). Magnesium chloride reduced pain (29%) and area of allodynia (18%) insignificantly. Following ketamine there was a significant correlation between the reduction in ongoing pain and reduction in area of touch-evoked allodynia. Detection and pain thresholds to mechanical and thermal stimuli were not significantly changed by the drugs, These findings suggest that both ongoing pain and touch-evoked pain (allodynia) in neuropathic pain are inter-related phenomena, which may be mediated by the same mechanism and involving a N-methyl-D-aspartate receptor.