A brief, high-dose remifentanil infusion partially reverses neuropathic pain in a subgroup of post herpetic neuralgia patients. (June 2017)

• Record Type: Journal Article
• Authors: Prosenz, Julian; Kloimstein, Herwig; Thaler, Ulrich; Drdla-Schutting, Ruth; Sandkühler, Jürgen; Gustorff, Burkhard
• Is Part Of: Journal of clinical neuroscience. Volume 40(2017:Jun.)
• Page Start: 195
• Page End: 197
• Publication Date: 2017-06
• Subjects: Chronic pain -- Neuropathic -- Post-herpetic neuralgia -- Mechanism-based -- Opioid -- Remifentanil; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2017.02.048
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Eleven of 20 patients responded to treatment. The mean reduction of spontaneous pain was 61% among responders after seven days. Patients who responded showed a reduction of mechanical hyperalgesia. Abstract: Mechanism-based therapy for chronic pain is desperately needed. Recent basic science research demonstrated that remifentanil can reverse long-term potentiation at C-fiber synapses in the dorsal horn of rats. In this exploratory, single group study, patients with chronic post-herpetic pain were treated with a single, one-hour, high-dose remifentanil infusion. The mean overall change of pain intensity seven days after treatment was −18 (−7.5; −28.5, 95%CI, p < 0.001) points on the numeric rating scale (0–100) (−33 (±11) points amongst responders only). Eleven of 20 patients responded to treatment (≥30% reduction in pain), the mean relative reduction in pain from baseline amongst responders was 61.0%. These promising preliminary results suggest that a mechanism-based reversal of chronic pain may be impending.