Sumatriptan alleviates pain in patients with trigeminal neuralgia
Sumatriptan alleviates pain in patients with trigeminal neuralgia
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DOI：
10.1097/01.ajp.0000210917.18536.0d
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发表时间：
2006-10-01
影响因子：
2.9
通讯作者：
Hoka, Sumio
中科院分区：
文献类型：
--
作者：
Kanai, Akifumi;Suzuki, Asaha;Hoka, Sumio
目的：三叉神经根的动脉受压可能导致三叉神经痛。 5-HT1B/1D 受体激动剂可以抑制受刺激的三叉神经根附近的血管舒张和炎症。最近的一项研究表明，在三叉神经痛大鼠模型中，5-HT1A 受体激动剂可减轻机械性异常性疼痛。本研究检验了 5-HT1A/1B/1D 受体激动剂舒马曲坦对三叉神经痛患者疼痛缓解的有效性。方法：该研究在 15 名特发性三叉神经痛患者中进行。患者遭受疼痛发作至少1个月。每位患者皮下注射 1 mL 生理盐水（安慰剂），15 分钟后皮下注射舒马普坦（3 mg 溶于 1 mL 生理盐水）。第二天口服舒马曲坦（50 mg，每日两次），持续 1 周。结果：生理盐水后视觉模拟量表没有变化，但皮下注射舒马曲坦后视觉模拟量表显着下降。口服舒马曲坦后 1 周和停药后 1 周，视觉模拟量表评分均较基线显着下降。 4 例患者皮下注射舒马曲坦后出现不良事件：疲劳 4 例，恶心 2 例。4 例患者出现口服药物副作用：疲劳 2 例，恶心 1 例，胸部不适 1 例。这些副作用在停止舒马曲坦后很快消退。结论：我们的研究结果表明，皮下注射然后口服舒马曲坦对三叉神经痛患者能产生迅速、持续的镇痛效果。
Objectives: Arterial compression of the trigeminal root may lead to trigeminal neuralgia. 5-HT1B/1D receptor agonists may inhibit vasodilation and inflammation near the irritated trigeminal root. A recent study showed attenuation of mechanical allodynia by a 5-HT1A receptor agonist in a rat model of trigeminal neuralgia. The present study examined the effectiveness of a 5-HT1A/1B/1D receptor agonist, sumatriptan, on pain relief in patients with trigeminal neuralgia.Methods: The study was conducted in 15 patients with idiopathic trigeminal neuralgia. The patients had been suffering from painful paroxysms for at least 1 month. Each patient was injected with 1 mL of saline subcutaneously (placebo), followed 15 minutes later with subcutaneous sumatriptan (3 mg in I mL saline). This was followed the next day by oral sumatriptan (50 mg twice daily) for 1 week.Results: The visual analog scale did not change after saline, but significantly decreased after subcutaneous sumatriptan. Both 1 week after oral sumatriptan and 1 week after discontinuation of the drug, visual analog scale scores resulted in a significant decrease from the baseline. Adverse events after subcutaneous sumatriptan occurred in 4 patients: fatigue in 4 and nausea in 2. Side effects from the oral medication appeared in 4 patients: fatigue in 2, nausea in 1 and chest discomfort in 1. These side effects subsided soon after discontinuation of sumatriptan.Conclusions: Our results indicate that subcutaneous injection followed by oral administration of sumatriptan produces prompt and continuous analgesia in patients with trigeminal neuralgia.