pharmazentrum frankfurt/ZAFES, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany.
Pain. 2009 Dec 15;147(1-3):116-21. doi: 10.1016/j.pain.2009.08.018. Epub 2009 Sep 16.
We investigated the analgesic efficacy of single doses of ibuprofen, tramadol and pregabalin in menthol-evoked cold pain in a randomized, placebo-controlled four-way cross-over study in 20 healthy volunteers. Tramadol 100mg significantly reduced menthol-evoked cold hyperalgesia. Effects of ibuprofen 600mg and pregabalin 100mg were not significant. Analgesic effects of tramadol were associated with minor side effects, particularly fatigue and nausea. Minor side effects also accompanied analgesic effects of pregabalin and ibuprofen in subjects responding to these drugs, mostly fatigue, dizziness and difficulties to concentrate for pregabalin and gastric upset for ibuprofen. Five out of 18 subjects had a 50% reduction of cold hyperalgesia with tramadol, three of these additionally responded to pregabalin, and two with all three drugs. The numbers needed to treat (NNT >or= 50% for tramadol 4.5, for pregabalin 9) largely agree with the reported efficacy of tramadol and of moderate dosages of pregabalin in patients with peripheral or central neuropathic pain suggesting that menthol-evoked cold pain hypersensitivity may represent a valid model for neuropathic pain, particularly cold allodynia.
我们在 20 名健康志愿者中进行了一项随机、安慰剂对照的四交叉研究，调查了单剂量布洛芬、曲马多和普瑞巴林在薄荷醇诱发的冷痛中的镇痛效果。曲马多 100mg 显著减轻了薄荷醇诱发的冷痛觉过敏。布洛芬 600mg 和普瑞巴林 100mg 的作用不显著。曲马多的镇痛作用与轻微的副作用有关，尤其是疲劳和恶心。普瑞巴林和布洛芬对这些药物有反应的受试者也伴有轻微的副作用，主要是疲劳、头晕和注意力难以集中（普瑞巴林）以及胃部不适（布洛芬）。18 名受试者中有 5 名对曲马多有 50%的冷痛觉过敏缓解，其中 3 名对普瑞巴林有反应，2 名对所有 3 种药物有反应。需要治疗的人数（NNT >或= 50%，曲马多 4.5，普瑞巴林 9）与报告的曲马多和中剂量普瑞巴林在周围或中枢神经性疼痛患者中的疗效基本一致，这表明薄荷醇诱发的冷痛觉过敏可能是神经性疼痛的有效模型，特别是冷感觉过敏。
