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Effect of transdermal opioids in experimentally induced superficial, deep and hyperalgesic pain

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

  • Trine Andresen
  • ,
  • C Staahl, Danmark
  • A Oksche
  • ,
  • H Mansikka
  • ,
  • Lars Arendt-Nielsen
  • ,
  • Am Drewes
Background and purpose: Chronic pain and hyperalgesia can be difficult to treat with classical opioids acting predominately at the µ-opioid receptor. Buprenorphine and its active metabolite are believed to act through µ-, κ- and δ-receptors and may therefore possess different analgesic and anti-hyperalgesic effects compared to pure µ-receptor agonists e.g. fentanyl. Here, we have compared the analgesic and anti-hyperalgesic effects of buprenorphine and fentanyl. Experimental approach: 22 healthy volunteers were randomized to treatment with transdermal buprenorphine (20µg/h, 144h), fentanyl (25µg/h, 72h) or placebo patches in a double-blind, cross-over experimental pain study. The experimental pain tests (phasic pain, sensitization) involved pressure at the tibial bone, cutaneous electrical and thermal stimulation, intramuscular nerve growth factor, UV-B light burn injury model and intradermal capsaicin-induced hyperalgesia. Pain testing was carried out at baseline, 24, 48, 72 and 144 hours after application of the drugs. Key Results: Compared to placebo, buprenorphine, but not fentanyl, significantly attenuated pressure at the tibial bone as well as pressure pain in the primary hyperalgesic area induced by UV-B light The two drugs were equipotent and better than placebo against cutaneous thermal pain stimulation), but failed to show significant analgesic effect to cutaneous electrical stimulation, nerve growth factor-induced muscle soreness and to capsaicin-induced hyperalgesia. Conclusions and implications: Buprenorphine, but not fentanyl, showed analgesic effects against experimentally induced, bone-associated pain and primary hyperalgesia compared to placebo. These tissue- and modality-differentiated properties may reflect the variable effects of opioid drugs observed in individual patients.
TidsskriftBritish Journal of Pharmacology
Sider (fra-til)934-45
Antal sider12
StatusUdgivet - 23 dec. 2011

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