Increased numbers of opioid expressing inflammatory cells do not affect intra-articular morphine analgesia

British Journal of Anaesthesia
R LikarM Schäfer

Abstract

Both locally expressed beta-endorphin (END) and low doses of morphine relieve pain within inflamed knee joints. Here we examined whether enhanced inflammation and END expression within the synovial tissue of patients undergoing arthroscopic knee surgery might shift the analgesic dose-response curve of intra-articular (i.a.) morphine. Following IRB approval and informed consent, patients were randomly assigned to the following i.a. treatments at the end of surgery: group I (n=39), isotonic saline; group II (n=40), 1 mg morphine hydrochloride; group III (n=48), 2 mg morphine hydrochloride; group IV (n=39), 4 mg morphine hydrochloride. Postoperative pain intensity was assessed by the visual analogue scale (VAS), by the time to first analgesic request and by the supplemental piritramide consumption. Synovial specimens from each patient were stained for the presence of inflammatory cells and END and were discriminated into groups with low versus high numbers of these cells. Differences between groups were statistically analyzed by chi(2), anova and mancova where appropiate. Patient characteristics and VAS scores did not differ between groups. Total postoperative piritramide consumption decreased and the time to first analgesic reque...Continue Reading

References

Oct 15, 1991·European Journal of Pharmacology·R BousselmameJ Costentin
Mar 19, 1982·Science·K A MiczekL Shuster
Jun 22, 1995·The New England Journal of Medicine·C Stein
Aug 7, 1993·Lancet·C SteinA Yassouridis
Aug 1, 1996·The Journal of Clinical Investigation·C SteinA H Hassan
Jul 1, 1997·The Journal of Clinical Investigation·P J CabotC Stein
Jan 5, 2000·British Journal of Anaesthesia·R LikarM Schäfer
Aug 29, 2001·Anesthesia and Analgesia·A GuptaL Berggren
Mar 15, 2002·Cell·Brigitte L Kieffer, Christopher J Evans
Nov 1, 2003·The Journal of Pharmacology and Experimental Therapeutics·Mohammed A ShaquraMichael Schäfer
Oct 4, 2006·Current Opinion in Anaesthesiology·M Schäfer

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Citations

Sep 1, 2005·Der Schmerz·J Oeltjenbruns, M Schäfer
Nov 28, 2007·Journal of Neuroimmune Pharmacology : the Official Journal of the Society on NeuroImmune Pharmacology·Halina Machelska, Christoph Stein
Dec 31, 2004·Current Pain and Headache Reports·Jochen Oeltjenbruns, Michael Schäfer
Jan 24, 2007·The Clinical Journal of Pain·Rudolf LikarMichael Schäfer
Mar 12, 2010·The Journal of Nursing Research : JNR·Yu-Hua Lin, Mei-Sang Yang
Jun 19, 2013·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Chao ZengGuang-hua Lei
Sep 4, 2015·Annual Review of Medicine·Christoph Stein
Nov 3, 2009·Brain, Behavior, and Immunity·Melanie Busch-Dienstfertig, Christoph Stein
Jan 20, 2009·Brain Research Reviews·Christoph SteinRobert H Spencer
Jul 21, 2007·Neuropeptides·Halina Machelska
Apr 29, 2009·Veterinary Anaesthesia and Analgesia·Luiz César Pereira SantosMere Erika Saito
Mar 17, 2010·Veterinary Anaesthesia and Analgesia·Casper LindegaardPia Haubro Andersen
Jul 26, 2005·Peptides·Richard J Bodnar, Gad E Klein
Aug 1, 2015·Veterinary Surgery : VS·Barbara G HunterChristopher K Cebra
Mar 19, 2013·European Journal of Pharmacology·Christoph Stein
May 4, 2016·Brain, Behavior, and Immunity·Melih Ö CelikHalina Machelska
Aug 28, 2018·Expert Opinion on Investigational Drugs·Christoph Stein
Aug 6, 2005·AACN Clinical Issues·Janean E HoldenJeannine M Forrest
Jan 12, 2019·International Reviews of Immunology·Hayk Minasyan, Friedrich Flachsbart
Dec 18, 2018·Frontiers in Pharmacology·Halina Machelska, Melih Ö Celik
Oct 5, 2011·Pharmacological Reviews·Christoph Stein, Halina Machelska

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