Arout Caroline A, Petrakis Ismene L, Ralevski Elizabeth, Acampora Gregory, Koretski Julia, DeNegre Diana, Newcomb Jenelle, Perrino Albert C
Department of Psychiatry, Center for Translational Neuroscience of Alcoholism and VA Alcohol Research Center, Yale University School of Medicine, VA Connecticut Healthcare System, West Haven, Connecticut.
Department of Psychiatry, Division on Substance Use Disorders, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York.
Pain Med. 2020 Nov 1;21(11):2823-2829. doi: 10.1093/pm/pnaa037.
Past investigations assessing the effects of thiopental on pain are conflicting. Although several studies demonstrate hyperalgesia as a result of barbiturate administration, others show analgesia. Our objective was to assess the effects of an infusion of the GABAA agonist thiopental, compared with placebo, in healthy participants on two subjective experimental pain paradigms: noxious electrical stimulation and intradermal capsaicin.
For electrical stimulation, the milliamps required to achieve pain threshold and tolerance were recorded, and the percent change from baseline was determined for each infusion condition. In the intradermal capsaicin condition, the area of hyperalgesia was determined by von Frey technique pre- and postinfusion, and the percent change in the area of hyperalgesia was calculated.
Though thiopental infusion resulted in an increase in the electrical stimulation current required to elicit pain threshold or reach pain tolerance when compared with baseline, this finding was not statistically significant. In the intradermal capsaicin condition, there was a statistically significant difference in overall pre- and postinfusion pain interpretation, as measured by the McGill Pain Questionnaire (P < 0.05), but there was no significant difference in area of hyperalgesia.
In this human study of thiopental's effects on two experimental pain models, our results show that thiopental does not induce hyperalgesia.
过去评估硫喷妥钠对疼痛影响的研究结果相互矛盾。尽管多项研究表明巴比妥类药物给药会导致痛觉过敏,但其他研究显示有镇痛作用。我们的目的是在健康参与者中,比较给予GABAA激动剂硫喷妥钠输注与安慰剂输注,对两种主观实验性疼痛范式(有害电刺激和皮内注射辣椒素)的影响。
对于电刺激,记录达到疼痛阈值和耐受所需的毫安数,并确定每种输注条件下相对于基线的变化百分比。在皮内注射辣椒素的情况下,通过von Frey技术在输注前后测定痛觉过敏区域,并计算痛觉过敏区域的变化百分比。
与基线相比,尽管硫喷妥钠输注导致引发疼痛阈值或达到疼痛耐受所需的电刺激电流增加,但这一发现无统计学意义。在皮内注射辣椒素的情况下,通过麦吉尔疼痛问卷测量,输注前后总体疼痛解读存在统计学显著差异(P < 0.05),但痛觉过敏区域无显著差异。
在这项关于硫喷妥钠对两种实验性疼痛模型影响的人体研究中,我们的结果表明硫喷妥钠不会诱发痛觉过敏。