Benzodiazepines and pain: effects of midazolam on the activities of nociceptive non-specific dorsal horn neurons in the rat spinal cord.

The high density of GABA-benzodiazepine receptors in the superficial dorsal horn suggests a possible involvement of benzodiazepines (BZs) in the modulation of spinal pain processes. In this electrophysiological study we have examined the effects of midazolam (MZ), a water-soluble short-acting BZ, on the activities of 57 nociceptive non-specific dorsal horn cells, one in each animal. Recordings were performed at lumbar level in unanesthetized decerebrate spinal rats before and following intravenous injection of MZ (1, 2 or 5 mg/kg). The spontaneous activity was weakly and significantly but not dose dependently reduced by MZ. For the total neuronal population MZ induced no significant effect on C-fiber evoked responses, whatever the dose used. More precise analysis shows that for 45/55 neurons the responses were slightly depressed, but this effect was not dose dependent. In contrast, A delta-fiber evoked responses were markedly and dose dependently depressed. These effects of MZ were reversed by intravenous administration of the antagonist flumazenil (FZ). Despite the fact that MZ displays a very weak effect on responses due to C-fiber stimulation, the possible involvement of BZs in the modulation of nociceptive transmission at the level of the dorsal horn is discussed on the basis of clinical and experimental findings, taking into account the role of GABAergic mechanisms in sensory events.