Articles: hyperalgesia.
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Traumatic nerve injury in man can often result in the development of neuropathy. An animal model of neuropathic hyperalgesia is produced by loose ligation of the sciatic nerve in the rat. We have examined the effect of pre-emptive treatment with a number of drugs on the development of hyperalgesia in this model. ⋯ In vehicle-treated animals the ipsilateral paw withdrawal threshold (118 +/- 7 g) was significantly lower (P < 0.0001, paired t-test) than the contralateral (195 +/- 7 g). In contrast, in animals pre-treated with clonidine no significant difference between ipsilateral (200 +/- 9 g) and contralateral (191 +/- 7 g) paw withdrawal thresholds was detected. Morphine pre-treatment was less effective in preventing development of hyperalgesia; however, whilst the ipsilateral (146 +/- 18 g) paw withdrawal threshold tended to be lower than the contralateral (183 +/- 8 g), this was not significant.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Clinical Trial
Secondary hyperalgesia is not affected by wound infiltration with bupivacaine.
The purpose of this study was to determine the effects of wound infiltration with bupivacaine on incisional pain and the zone of secondary hyperalgesia. Twenty-eight healthy parturients were studied in a double-blind randomized trial. At the time of Caesarean section one wound edge was infiltrated with saline 0.9% and the other with bupivacaine 0.25%. ⋯ The zone of secondary pain was similar overall for both sides of the wound. It is concluded that the bupivacaine-infiltrated side of the wound was less painful than the saline-injected side 24 hr postoperatively. The zone of pain measured around the wound edges was unaffected by bupivacaine or saline.
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Thermal hyperalgesia was induced by UV irradiation of the glabrous skin of the hindpaw of adult female Sprague-Dawley rats. We have recorded single cell activity and studied excitability changes in wide dynamic range neurons in the lumbar spinal segments during the early phase (days 1-3) and late phase (days 5-7) of thermal hyperalgesia in animals under urethane anaesthesia. The proportion of spontaneously active wide dynamic range cells was increased following UV irradiation and the degree of spontaneous activity was enhanced during the course of hyperalgesia. ⋯ Cutting the dorsal roots (L2-5) evoked a significantly larger and more prolonged discharge in wide dynamic range cells in both UV-treated groups in comparison to control. Spontaneous activity in spinal wide dynamic range neurons was reduced after rhizotomy in each group. However, the decrease was only significant at days 1-3 (P < 0.05) but not at days 5-7.(ABSTRACT TRUNCATED AT 250 WORDS)
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Case Reports
Hyperalgesia and myoclonus in terminal cancer patients treated with continuous intravenous morphine.
Eight cancer patients in the terminal stages of the disease treated with high doses of intravenous morphine developed hyperalgesia. All cases were retrospectively sampled from three different hospitals in Copenhagen. ⋯ Although only few clinical descriptions of the relationship between hyperalgesia/myoclonus and high doses of morphine are available, experimental support from animal studies indicates that morphine, or its metabolites, plays a causative role for the observed behavioural syndrome. The possible mechanisms are discussed and treatment proposals given suggesting the use of more efficacious opioids with less excitatory potency in these situations.
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J. Pharmacol. Exp. Ther. · Sep 1993
Comparative StudyProstaglandin E2-induced thermal hyperalgesia and its reversal by morphine in the warm-water tail-withdrawal procedure in rhesus monkeys.
Four monkeys were seated in primate restraint chairs and the terminal 10 cm of their shaved tails were dipped into water maintained at a series of temperatures ranging from 38-54 degrees C. The latency to tail withdrawal from several temperatures was measured and temperature-effect curves for each monkey were generated. When administered s.c. into the tail, prostaglandin E2 (PGE2; 0, 1.58, 5.0 and 15.8 micrograms) produced a dose-dependent hyperalgesia manifested as dose-dependent leftward shifts in the temperature-effect curves. ⋯ The hyperalgesic effects of PGE2 were reversed potently by morphine (0.32-3.2 mg/kg), and the effects of morphine were antagonized in a surmountable manner by both the opioid antagonist quadazocine (0.1 mg/kg) and by systemic administration of the charged opioid antagonist quaternary naltrexone (3.2 mg/kg). These results indicate that PGE2 produces thermal hyperalgesia in rhesus monkeys and also suggests that this hyperalgesia may be reversed by activation of peripheral opioid receptors. PGE2-induced hyperalgesia in the warm-water tail-withdrawal procedure may provide a useful assay for evaluating the effects of pharmacological and nonpharmacological treatments on hyperalgesia associated with inflammation in primates.