Schmidt Brian L, Gear Robert W, Levine Jon D
Department of Oral and Maxillofacial Surgery, C-522 (Box 0440), University of California at San Francisco, 521 Parnassus Avenue, San Francisco, CA 94143-0440, USA.
Neurosci Lett. 2003 Jun 5;343(2):144-6. doi: 10.1016/s0304-3940(03)00356-2.
We report on the response of medically refractory neuropathic trigeminal pain in three patients to intravenous administration of a combination of the kappa-partial agonist opioid nalbuphine and the opioid antagonist naloxone. Each of the three patients had developed a painful peripheral neuropathy as a complication of chemical or mechanical injury to the trigeminal nerve. Each patient had been tried on a number of analgesics, including mu-opioids, and had not gained relief or was not able to tolerate side effects of the medications. Pain intensity was measured for 3 h following drug administration using a 10 cm visual analog scale. All three patients reported marked decrease in pain following administration of the nalbuphine and naloxone combination. These findings suggest a novel approach to the management for neuropathic pain.
我们报告了3例药物难治性三叉神经痛患者静脉注射κ-部分激动剂阿片类药物纳布啡和阿片类拮抗剂纳洛酮联合用药后的反应。这3例患者均因三叉神经受到化学或机械损伤而并发疼痛性周围神经病变。每位患者都尝试过多种镇痛药，包括μ-阿片类药物，但均未缓解疼痛或无法耐受药物的副作用。用药后使用10厘米视觉模拟量表测量3小时的疼痛强度。所有3例患者均报告在使用纳布啡和纳洛酮联合用药后疼痛明显减轻。这些发现提示了一种治疗神经性疼痛的新方法。
