Staahl Camilla, Dimcevski Georg, Andersen Søren Due, Thorsgaard Niels, Christrup Lona L, Arendt-Nielsen Lars, Drewes Asbjørn Mohr
Centre for Visceral Biomechanics and Pain, Department of Gastroenterology, University Hospital Aalborg, Denmark.
Scand J Gastroenterol. 2007 Mar;42(3):383-90. doi: 10.1080/00365520601014414.
Animal experiments and clinical observations have indicated a different working profile of oxycodone compared to morphine, and it has previously been shown that oxycodone attenuates visceral pain better than morphine. The objective of this study was to test the effects of oxycodone and morphine on experimental pain in patients with pain caused by chronic pancreatitis.
Ten patients took part in this blinded, cross-over study. The analgesic effects of morphine (30 mg, oral), oxycodone (15 mg, oral) and placebo were tested against multimodal (mechanical, thermal and electrical) experimental pain in the skin, muscles and oesophagus. Pain was assessed at baseline and 30, 60 and 90 min after drug administration.
In the skin and muscles, oxycodone was more effective than placebo and morphine on mechanically (skin: F=12.4, p<0.001, muscle: F=11.0, p<0.001) and thermally (skin: F=8.5, p<0.001) evoked pain. In oesophageal heat pain, the effect of morphine was equal to that of placebo, while oxycodone attenuated pain better than both morphine and placebo (F=9.5, p<0.001). Both morphine and oxycodone were more effective in attenuating mechanical pain in the oesophagus than placebo (F=8.6, p<0.001). After electrical stimulation no differences were seen between the opioids and placebo in any tissue studied.
Oxycodone was a stronger analgesic than morphine in several pain modalities in the skin, muscle and oesophagus.
动物实验和临床观察表明，与吗啡相比，羟考酮的作用模式有所不同，且此前已表明羟考酮在减轻内脏疼痛方面比吗啡更有效。本研究的目的是测试羟考酮和吗啡对慢性胰腺炎所致疼痛患者实验性疼痛的影响。
10名患者参与了这项双盲交叉研究。针对皮肤、肌肉和食管的多模式（机械性、热性和电性）实验性疼痛，测试了吗啡（30毫克，口服）、羟考酮（15毫克，口服）和安慰剂的镇痛效果。在给药前及给药后30、60和90分钟评估疼痛情况。
在皮肤和肌肉方面，羟考酮在减轻机械性（皮肤：F = 12.4，p < 0.001，肌肉：F = 11.0，p < 0.001）和热性（皮肤：F = 8.5，p < 0.001）诱发疼痛方面比安慰剂和吗啡更有效。在食管热痛方面，吗啡的效果与安慰剂相当，而羟考酮减轻疼痛的效果优于吗啡和安慰剂（F = 9.5，p < 0.001）。吗啡和羟考酮在减轻食管机械性疼痛方面均比安慰剂更有效（F = 8.6，p < 0.001）。在电刺激后，在所研究的任何组织中，阿片类药物与安慰剂之间均未观察到差异。
在皮肤、肌肉和食管的几种疼痛模式中，羟考酮是比吗啡更强效的镇痛药。
