%0 Journal Article
%T Morphine- and buprenorphine-induced analgesia and antihyperalgesia in a human inflammatory pain model: a double-blind, randomized, placebo-controlled, five-arm crossover study
%A Ravn P
%A Secher EL
%A Skram U
%A Therkildsen T
%A Christrup LL
%A Werner MU
%J Journal of Pain Research
%D 2013
%I Dove Medical Press
%R http://dx.doi.org/10.2147/JPR.S36827
%X rphine- and buprenorphine-induced analgesia and antihyperalgesia in a human inflammatory pain model: a double-blind, randomized, placebo-controlled, five-arm crossover study Original Research (1040) Total Article Views Authors: Ravn P, Secher EL, Skram U, Therkildsen T, Christrup LL, Werner MU Published Date January 2013 Volume 2013:6 Pages 23 - 38 DOI: http://dx.doi.org/10.2147/JPR.S36827 Received: 08 August 2012 Accepted: 25 September 2012 Published: 09 January 2013 Pernille Ravn,1 Erik L Secher,2 Ulrik Skram,3 Trine Therkildsen,1 Lona L Christrup,1 Mads U Werner4 1Department of Drug Design and Pharmacology, University of Copenhagen, 2Department of Anesthesiology, Juliane Marie Center, Rigshospitalet, Copenhagen University Hospitals, 3Department of Intensive Care, Gentofte Hospital, Copenhagen University Hospitals, 4Multidisciplinary Pain Center, Neuroscience Center, Rigshospitalet, Copenhagen University Hospitals, Copenhagen, Denmark Purpose: Opioid therapy is associated with the development of tolerance and paradoxically increased sensitivity to pain. It has been suggested that buprenorphine is associated with a higher antihyperalgesia/analgesia ratio than ¦Ì-opioid receptor agonists. The primary outcome of this study was therefore to investigate relative differences in antihyperalgesia and analgesia effects between morphine and buprenorphine in an inflammatory pain model in volunteers. The secondary outcome was to examine the relationship between pain sensitivity and opioid-induced effects on analgesia, antihyperalgesia, and descending pain modulation. Subjects and methods: Twenty-eight healthy subjects were included. The study was a double-blind, randomized, placebo-controlled, five-arm crossover study with a multimodal (electrical, mechanical, and thermal stimuli) testing technique. After baseline assessments, intravenous infusions of morphine (10/20 mg), buprenorphine (0.3/0.6 mg), or placebo (normal saline) were administered over a 210-minute period, during which a cold pressor test, heat injury (47¡ãC, 7 minutes, 12.5 cm2), and the first postburn assessment were done. After completion of the drug infusions, two additional postburn assessments were done. The subjects were monitored during each 8-hour session by an anesthesiologist. Results: For nearly all tested variables, significant dose-dependent analgesic effects were demonstrated. The median antihyperalgesia/analgesia ratio (secondary hyperalgesia/heat injury relative to placebo) for low-dose morphine was 0.01 (interquartile range:  6.2; 9.9), 0.00 ( 2.4; 2.1) for high-dose morphine, 0.03 ( 1.8; 2.1) for low-dose buprenorphine, and 0.00 ( 3.2; 1.1) for high-dose buprenorphine (P > 0.466). There were no significant differences in opioid responses between high and low pain-sensitive subjects (P > 0.286). High-dose buprenorphine, compared to placebo, was associated with a significantly enhanced action of the descending inhibitory pain control system (P = 0.004). Conclusion: The present s
%K analgesia
%K antihyperalgesia
%K experimental pain
%K opioid
%K pain sensitivity
%K randomized trial
%U https://www.dovepress.com/morphine--and-buprenorphine-induced-analgesia-and-antihyperalgesia-in--peer-reviewed-article-JPR