Glynn C J, Jamous M A, Teddy P J, Moore R A, Lloyd J W
Lancet. 1986 Nov 29;2(8518):1249-50. doi: 10.1016/s0140-6736(86)92678-4.
15 patients with deafferentation pain due to spinal cord injury were investigated for a spinal mechanism of pain transmission. Epidural morphine 5 mg in 5 ml of water had an analgesic effect in 5 patients, 3 of whom also had pain relief with epidural clonidine. Epidural clonidine 150 micrograms in 5 ml of saline had an analgesic effect in 7 patients who did not respond to epidural morphine. Neither epidural morphine nor clonidine was effective in the other 3 patients, 2 of whom obtained relief with epidural buprenorphine 0.3 mg in 5 ml of saline. 1 patient did not find relief with any of the injections. These data suggest that a spinal noradrenergic system may be as important as the opioid system in the transmission of pain in patients with spinal cord injury.
对15例因脊髓损伤导致去传入性疼痛的患者进行了疼痛传导脊髓机制的研究。5毫克吗啡溶于5毫升水中进行硬膜外注射，对5例患者有镇痛作用，其中3例患者硬膜外注射可乐定后疼痛也得到缓解。150微克可乐定溶于5毫升生理盐水中进行硬膜外注射，对7例硬膜外注射吗啡无效的患者有镇痛作用。硬膜外注射吗啡和可乐定对另外3例患者均无效，其中2例患者在5毫升生理盐水中注射0.3毫克丁丙诺啡后疼痛缓解。1例患者对任何注射均无反应。这些数据表明，在脊髓损伤患者的疼痛传导中，脊髓去甲肾上腺素能系统可能与阿片系统同样重要。
