European journal of pain : EJP
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Although the antinociceptive effect of NMDA antagonists in the formalin test is well recognised, these compounds can induce adverse motor effects. The aim of this study was to identify the systemic doses of NMDA antagonists that induce analgesia without causing side effects. Male Swiss mice (30-40g) received a subcutaneous (sc) injection of 1.25% formalin (50 micro l) in the dorsal surface of the right hind-paw and, 15min before or after formalin, an ip injection of one of the following NMDA receptor antagonists: MK 801 (0.01, 0.025, and 0.05mg/kg), memantine (0.1, 0.5, and 1mg/kg), ketamine (0.125, 0.25, and 0.5mg/kg), dextromethorphan (5, 10, and 20mg/kg), and CGP 37849 (4, 6, and 8mg/kg). ⋯ The rank order potency of antinociceptive activity of NMDA antagonists was: MK801>memantine>ketamine>dextromethorphan>CGP37849. The NMDA antagonists administered after formalin (during the analgesic interval) did not affect the late phase of the formalin test. In conclusion, systemic administration of NMDA receptor antagonists decreases the nociception observed during the late phase of the formalin test.
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This study examined the relative capacity of Adelta- and C-fibers to encode non-painful and painful brief CO(2) laser stimuli by comparing the effects of Adelta/C-fiber activation versus C-fiber activation alone. In nine normal subjects, brief CO(2) laser pulses of four different intensities (range 5.8-10.6mJ/mm(2)) were delivered at random on the first intermetacarpal zone of the dorsum of the hand. A-fiber pressure block of the superficial radial nerve was performed to fully isolate the activity of C-fibers. ⋯ Median RT increased from 492 to 1355ms. The late LEPs, attributed to the activation of Adelta-fibers, disappeared and ultra-late LEPs were recorded at Cz with a positivity peaking around 800ms. Collectively, these observations lead to the conclusion that Adelta-fibers are the main peripheral mediators for the perception of brief CO(2) laser stimuli and that they provide more sensory information than C-fibers.
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Synthetic heat is a perception of strong, but not painful, heat arising when skin is stimulated by an alternating pattern of adjacent cold and warmth. This study examines the contribution of different classes of nerve fibres to this perception. In 40 subjects changes in synthetic heat and thermal perceptions were studied during a 30-min ischaemic nerve block in one reaction time, and one threshold determination task. ⋯ It is concluded that the perception of synthetic heat most likely arises from the fusion of signals dependent on unmyelinated low threshold cold and warm receptors. It is not dependent on A-delta cold fibres, and a contribution of nociceptors is quite unlikely. The possibility of a psychological contribution at the perceptual level is discussed.
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Editorial Comment
Appropriate and responsible use of opioids in chronic non-cancer pain.