S Canavero1, V Bonicalzi. 1. Turin Advanced Neuromodulation Group, Turin, Italy. solara@infinito.it
Abstract
OBJECTIVE: To validate IV subhypnotic propofol, a gamma-aminobutyric acid A (GABA-A) agonist, as a diagnostic test for central pain. METHODS: The efficacy of systemic propofol (0.2 mg/kg IV bolus) was evaluated in a double-blind, placebo-controlled and crossover fashion on both spontaneous ongoing pain and allodynia in 44 patients with chronic central pain of both brain and cord origin. RESULTS:Propofol was significantly superior to the placebo (Intralipid, Kabi Pharmacia) in reducing the intensity of spontaneous ongoing pain for up to 1 hour after the injection: 24 of 44 patients (55%) receiving propofol showed a significant reduction in spontaneous pain, whereas only 6 patients showed this after the placebo. Propofol also significantly reduced the intensity of both mechanical and cold allodynia. In a few cases, only the evoked components were abolished but not the spontaneous pain. In general, the side effects were minimal and consisted mainly of transitory burning upon injection of both propofol and placebo and slight lightheadedness in a few cases. CONCLUSIONS:Systemic propofol induces analgesic effects on all studied components of central pain and highlights the key role of GABA modulation in central pain.
RCT Entities:
OBJECTIVE: To validate IV subhypnotic propofol, a gamma-aminobutyric acid A (GABA-A) agonist, as a diagnostic test for central pain. METHODS: The efficacy of systemic propofol (0.2 mg/kg IV bolus) was evaluated in a double-blind, placebo-controlled and crossover fashion on both spontaneous ongoing pain and allodynia in 44 patients with chronic central pain of both brain and cord origin. RESULTS:Propofol was significantly superior to the placebo (Intralipid, Kabi Pharmacia) in reducing the intensity of spontaneous ongoing pain for up to 1 hour after the injection: 24 of 44 patients (55%) receiving propofol showed a significant reduction in spontaneous pain, whereas only 6 patients showed this after the placebo. Propofol also significantly reduced the intensity of both mechanical and cold allodynia. In a few cases, only the evoked components were abolished but not the spontaneous pain. In general, the side effects were minimal and consisted mainly of transitory burning upon injection of both propofol and placebo and slight lightheadedness in a few cases. CONCLUSIONS: Systemic propofol induces analgesic effects on all studied components of central pain and highlights the key role of GABA modulation in central pain.
Authors: Thomas N Bryce; Cecilia Norrbrink Budh; Diana D Cardenas; Marcel Dijkers; Elizabeth R Felix; Nanna B Finnerup; Paul Kennedy; Thomas Lundeberg; J Scott Richards; Diana H Rintala; Philip Siddall; Eva Widerstrom-Noga Journal: J Spinal Cord Med Date: 2007 Impact factor: 1.985
Authors: Tae Ha Lim; Soo Il Choi; Jee In Yoo; Young Soon Choi; Young Su Lim; Bo Hyun Sang; Yun Sic Bang; Young Uk Kim Journal: Korean J Pain Date: 2016-04-01