Bainton Tony, Fox Mark, Bowsher David, Wells Chris
Centre for Pain Relief and Pain Research Institute, Walton Hospital, Liverpool L9 1AE UK.
Pain. 1992 Feb;48(2):159-162. doi: 10.1016/0304-3959(92)90052-D.
Intravenous naloxone has been claimed to produce pain relief in opioid-resistant central post-stroke pain (CPSP, 'thalamic syndrome'). In a double-blind trial, carried out in 20 patients with established CPSP, naloxone (up to 8 mg in 20 ml vehicle) was tested against normal saline; each patient was randomly given naloxone or saline and the other substance 2 or 3 weeks later. VAS and verbal pain scores were obtained immediately before and after naloxone or saline injection, and subjective ratings followed for 2 weeks. Three patients obtained transient pain relief with naloxone, 4 with saline, and another 4 with both. Statistical tests failed to show any influence of giving naloxone first or second. In all cases except one, pain relief had disappeared by the evening of the day on which the test was performed; one case, following naloxone, continued to experience pain relief until the following morning. We therefore conclude that intravenous naloxone is of no value in alleviating the pain of CPSP.
静脉注射纳洛酮据称可缓解对阿片类药物耐受的中风后中枢性疼痛（CPSP，“丘脑综合征”）。在一项针对20例确诊为CPSP患者的双盲试验中，将纳洛酮（在20毫升溶媒中高达8毫克）与生理盐水进行对比测试；每位患者随机先接受纳洛酮或生理盐水注射，2至3周后再接受另一种物质注射。在注射纳洛酮或生理盐水之前及之后立即获取视觉模拟评分（VAS）和疼痛言语评分，并持续2周进行主观评级。3例患者使用纳洛酮后获得短暂疼痛缓解，4例使用生理盐水后缓解，另有4例两者注射后均有缓解。统计学检验未显示先注射或后注射纳洛酮有任何影响。除1例外，在进行测试当天晚上，所有病例的疼痛缓解均已消失；1例在注射纳洛酮后，持续经历疼痛缓解直至次日早晨。因此，我们得出结论，静脉注射纳洛酮对缓解CPSP疼痛无价值。
