The effect of intradermal administration of lidocaine and morphine on the response to thermal stimulation

Anesthesia and Analgesia
Peter G AtanassoffDavid G Silverman

Abstract

Opioids appear to exert a peripheral effect by gaining access to peripheral opioid receptors. It has been proposed that inflammatory processes and highly osmotic substances could alter the perineural barrier, thereby allowing easy access to opioid receptors. Although local anesthetics do not have osmotic activity, they are highly active on neural tissue and appear to work synergistically with opioids when administered for major conduction blockade. We therefore evaluated, in a double-blind fashion, the combination of lidocaine plus morphine in an attempt to provide a scientific basis for the use of a combination of morphine plus local anesthetics in the periphery. Seven thermal stimuli in 2 degrees C increments (range 40-52 degrees C) were delivered in a random sequence by a computer-controlled thermistor to one of three pretreated sites on 10 volunteers' forearms: reference site (no injection), lidocaine site (0.1-mL intradermal injection of lidocaine 0.5%), or lidocaine plus morphine site (0.1 mL of 0.5 mg of morphine plus lidocaine 1%). Pain responses to the thermal stimuli were rated by the volunteers using the method of magnitude estimation. Pain scores indicated that the combination of lidocaine plus morphine was not more...Continue Reading

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Citations

Sep 18, 1999·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·V VarkelM Soudry
Feb 1, 2003·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Maximilian W B HartmannsgruberDavid G Silverman
Feb 24, 2012·Pharmacological Reports : PR·Tufan MertDilek Ozcengiz
Nov 4, 2011·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Sukanya MitraRavi K Gupta
Mar 10, 2007·The Journal of Pharmacology and Experimental Therapeutics·Kelly A BergWilliam P Clarke

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