Okkerse Pieter, van Amerongen Guido, de Kam Marieke L, Stevens Jasper, Butt Richard P, Gurrell Rachel, Dahan Albert, van Gerven Joop M, Hay Justin L, Groeneveld Geert Jan
Centre for Human Drug Research (CHDR), Leiden, The Netherlands.
Neuroscience and Pain Research Unit, Pfizer Worldwide Research and Development, Cambridge, UK.
Br J Clin Pharmacol. 2017 May;83(5):976-990. doi: 10.1111/bcp.13183. Epub 2017 Jan 9.
The aim was to investigate the ability of a battery of pain models to detect analgesic properties of commonly used analgesics in healthy subjects.
The battery consisted of tests eliciting electrical, mechanical and thermal (contact heat and cold pressor)-pain and included a UVB model, the thermal grill illusion and a paradigm of conditioned pain modulation. Subjects were administered fentanyl 3 μg kg , phenytoin 300 mg, (S)-ketamine 10 mg and placebo (part I), or imipramine 100 mg, pregabalin 300 mg, ibuprofen 600 mg and placebo (part II). Pain measurements were performed at baseline and up to 10 h post-dose. Endpoints were analysed using a mixed model analysis of variance.
Sixteen subjects (8 female) completed each part. The pain tolerance threshold (PTT) for electrical stimulation was increased (all P < 0.05) compared to placebo for (S)-ketamine (+10.1%), phenytoin (+8.5%) and pregabalin (+10.8%). The PTT for mechanical pain was increased by pregabalin (+14.1%). The cold pressor PTT was increased by fentanyl (+17.1%) and pregabalin (+46.4%). Normal skin heat pain detection threshold was increased by (S)-ketamine (+3.3%), fentanyl (+2.8%) and pregabalin (+4.1%). UVB treated skin pain detection threshold was increased by fentanyl (+2.6%) and ibuprofen (+4.0%). No differences in conditioned pain modulation were observed.
This study shows that these pain models are able to detect changes in pain thresholds after administration of different classes of analgesics in healthy subjects. The analgesic compounds all showed a unique profile in their effects on the pain tasks administered.
本研究旨在探究一系列疼痛模型检测常用镇痛药对健康受试者镇痛特性的能力。
该系列模型包括引发电、机械和热(接触热和冷加压)疼痛的测试,还包括紫外线B模型、热格栅错觉模型和条件性疼痛调制范式。受试者分别接受3μg/kg芬太尼、300mg苯妥英、10mg(S)-氯胺酮和安慰剂(第一部分),或100mg丙咪嗪、300mg普瑞巴林、600mg布洛芬和安慰剂(第二部分)。在基线和给药后长达10小时进行疼痛测量。使用混合模型方差分析对终点进行分析。
16名受试者(8名女性)完成了每个部分。与安慰剂相比,(S)-氯胺酮(增加10.1%)、苯妥英(增加8.5%)和普瑞巴林(增加10.8%)使电刺激的疼痛耐受阈值(PTT)升高(所有P<0.05)。普瑞巴林使机械性疼痛的PTT升高(增加14.1%)。芬太尼(增加17.1%)和普瑞巴林(增加46.4%)使冷加压PTT升高。(S)-氯胺酮(增加3.3%)、芬太尼(增加2.8%)和普瑞巴林(增加4.1%)使正常皮肤热痛检测阈值升高。芬太尼(增加2.6%)和布洛芬(增加4.0%)使紫外线B处理皮肤的疼痛检测阈值升高。未观察到条件性疼痛调制的差异。
本研究表明,这些疼痛模型能够检测健康受试者服用不同类别镇痛药后疼痛阈值的变化。所有镇痛化合物在对所施用疼痛任务的影响方面均表现出独特的特征。