Banik Ratan K, Johns Malcolm E, Sia Twan, Simone Donald A
Department of Anesthesiology, School of Medicine, University of Minnesota, Minneapolis, MN, United States.
Stanford University School of Medicine, Stanford, CA, United States.
Front Pain Res (Lausanne). 2025 Aug 13;6:1569246. doi: 10.3389/fpain.2025.1569246. eCollection 2025.
The use of non-opioid multimodal analgesics (NMA) may enhance pain relief and decrease opioid dependence in managing acute incisional pain, although this remains debated. A clinical trial found NMA ineffective compared to placebo, prompting us to investigate its impact on pain-like behaviors in animal models. In our study, 12 rats underwent plantar incision surgery and were divided into two groups: NMA and vehicle. NMA comprised acetaminophen, celecoxib, gabapentin, and dextromethorphan, with dosages based on human equivalents. We measured paw withdrawal latency (PWL), paw withdrawal threshold (PWT), and spontaneous foot lifting (SFL) behaviors. Before injection, there were no significant differences between the groups in PWL, PWT, or SFL. After treatment, PWL increased in NMA-injected rats (9.8 ± 2.2 s) compared to vehicle (5.9 ± 2.7 s; = 0.02). SFL frequency decreased in NMA-injected rats (8.0 ± 5.0 count/20-min) vs. vehicle (30.7 ± 18.0 count/20-min; = 0.013). However, PWT and SFL duration showed no significant changes. This research represents the first exploration of NMA's effects on incisional pain, suggesting it may effectively manage acute postsurgical pain with inflammatory and neuropathic components. Further clinical validation is needed, but our results indicate NMA could be a viable opioid alternative.
使用非阿片类多模式镇痛药（NMA）可能会增强疼痛缓解效果，并减少在处理急性切口疼痛时的阿片类药物依赖，尽管这一点仍存在争议。一项临床试验发现，与安慰剂相比，NMA无效，这促使我们研究其对动物模型中疼痛样行为的影响。在我们的研究中，12只大鼠接受了足底切口手术，并分为两组：NMA组和赋形剂组。NMA由对乙酰氨基酚、塞来昔布、加巴喷丁和右美沙芬组成，剂量基于人体等效剂量。我们测量了爪退缩潜伏期（PWL）、爪退缩阈值（PWT）和自发举足（SFL）行为。注射前，两组在PWL、PWT或SFL方面没有显著差异。治疗后，与赋形剂组（5.9±2.7秒）相比，注射NMA的大鼠PWL增加（9.8±2.2秒；P=0.02）。注射NMA的大鼠SFL频率（8.0±5.0次/20分钟）低于赋形剂组（30.7±18.0次/20分钟；P=0.013）。然而，PWT和SFL持续时间没有显著变化。这项研究首次探索了NMA对切口疼痛的影响，表明它可能有效管理具有炎症和神经病理性成分的急性术后疼痛。需要进一步的临床验证，但我们的结果表明NMA可能是一种可行的阿片类替代药物。
