Pain-relieving effects of intravenous ATP in chronic intractable orofacial pain: an open-label study
Pain-relieving effects of intravenous ATP in chronic intractable orofacial pain: an open-label study
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DOI：
10.1007/s00540-006-0444-3
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发表时间：
2007-01-01
影响因子：
2.8
通讯作者：
Kaneko, Yuzuru
中科院分区：
文献类型：
--
作者：
Fukuda, Kenn-ichi;Hayashida, Masakazu;Kaneko, Yuzuru
目的.慢性口面疼痛通常是传统疼痛疗法难以治疗的。我们进行了一项开放性研究，以确定腺苷5 '-三磷酸（ATP）是否可以缓解慢性顽固性口面部疼痛，如果是这样，哪种类型的疼痛可以响应ATP。在8例和16例非神经性和神经性顽固性口面部疼痛患者中，分别以100 μ g·kg（-1）·min（-1）的速率静脉输注ATP 120分钟。自发性疼痛和刷子诱发的异常性疼痛的程度用视觉模拟量表（VAS）分级。当自发性疼痛的VAS评分通过ATP降低50%或更多时，患者被归类为应答者。患者可明确分为10个应答者和14个无应答者。16例神经性疼痛患者中有10例（62.5%）对ATP有反应，而8例非神经性疼痛患者中无一人对ATP有反应。特别是，所有8例牙髓切除术后神经性疼痛的患者，无论是否随后拔牙，对ATP都有反应。在10例应答者中，自发性疼痛的VAS评分在输注期间缓慢但进行性降低，并最终降低。ATP使自发性疼痛和异常性疼痛的VAS评分分别降低了82 +/- 15%和74 +/-9%。在这些响应者。ATP的镇痛和抗异常性疼痛作用持续时间的中位数为7和12小时。respectively.Conclusion.静脉注射ATP不能缓解非神经性口面部疼痛。然而，它发挥缓慢表达，但持久的镇痛和抗异常性疼痛的神经性口面部疼痛的患者，特别是在那些患有神经性疼痛牙髓切除术和/或拔牙。
Purpose. Chronic orofacial pain is often refractory to conventional pain therapies. We conducted an open-label study to determine whether adenosine 5'-triphosphate (ATP) could alleviate chronic intractable orofacial pain, and if so, which type of pain could respond to ATP.Methods. In 8 and 16 patients with non-neuropathic and neuropathic intractable orofacial pain, respectively, ATP was intravenously infused at a rate of 100 mu g-kg(-1).min(-1) over 120min. The magnitudes of spontaneous pain and brush-evoked allodynia were graded with a visual analog scale (VAS). When a VAS score for spontaneous pain was decreased by 50% or more by ATP, the patient was classified as a responder.Results. The patients could be clearly divided into 10 responders and 14 non-responders. Ten of the 16 patients (62.5%) with neuropathic pain, but none of the 8 patients with non-neuropathic pain, responded to ATP. In particular, all of 8 patients with neuropathic pain following pulpectomy, with or without subsequent tooth extraction, responded to ATP. In the 10 responders, VAS scores for spontaneous pain decreased slowly but progressively during the infusion period, and eventually. ATP reduced the VAS scores for spontaneous pain and allodynia by 82 +/- 15% and 74 +/- 9%, respectively. In these responders. the analgesic and anti-allodynic effects of ATP outlasted the infusion period for medians of 7 and 12h. respectively.Conclusion. Intravenous ATP did not relieve non-neuropathic orofacial pain. However, it exerted slowly expressed but long-lasting analgesic and anti-allodynic effects in patients with neuropathic orofacial pain, especially in those suffering from neuropathic pain following pulpectomy and/or tooth extraction.