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The analgesic effect of morphine and lidocaine on central post-stroke pain
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Surgical Sciences.
Manuscript (Other academic)
Identifiers
URN: urn:nbn:se:uu:diva-91048OAI: oai:DiVA.org:uu-91048DiVA: diva2:163626
Available from: 2003-11-19 Created: 2003-11-19 Last updated: 2010-01-13Bibliographically approved
In thesis
1. Neuropathic Pain; Quality of Life, Sensory Assessments and Pharmacological Treatments
Open this publication in new window or tab >>Neuropathic Pain; Quality of Life, Sensory Assessments and Pharmacological Treatments
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Neuropathic pain of central and peripheral origin presents a substantial clinical problem as it is often resistant to pharmacological treatment.

The health related quality of life of 126 patients with peripheral neuropathic pain was studied, to provide a cross sectional description from this point of view. Two generic health-related quality of life instruments; the SF-36 and the Nottingham Health Profile were used together with pain assessments, global rating of health and verbal rating scales of pain and other symptoms, as well as patient descriptors.

The analgesic effect of ketamine, lidocaine and morphine were assessed in a double blind, placebo-controlled, randomized study design. Three groups of patients were studied: patients with peripheral neuropathic pain of traumatic origin, patients with central post-stroke pain and patients with neuropathic pain after spinal cord injury. Somatosensory function was examined to see if this could predict response to treatment and to investigate if the drugs caused changes in thermal or mechanical sensibility.

The results shows that the intense pain, limited efficacy and tolerability of available treatments, the low overall rating of health, reduced work status and troublesome symptoms constitute a substantial impact on the quality of life for patients with peripheral neuropathic pain.

The NMDA-antagonist ketamine yielded substantial pain relief to patients with peripheral neuropathic pain and patients with neuropathic pain after spinal cord injury. However, the reported side effects limit the clinical usefulness of the treatment. Lidocaine did not give significant pain relief to the patients in the three studied groups. Morphine may represent a therapeutic alternative for some patients with central post-stroke pain, although only a small group of this category of patients responded with analgesia.

Assessment of baseline somatosensory functions could not be used to identify responders to treatment with either drug, nor did ketamine, lidocaine or morphine cause any changes in thermal or mechanical sensibility.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2003. 107 p.
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1302
Keyword
Anaesthesiology and intensive care, neuropathic pain, Anestesiologi och intensivvård
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:uu:diva-3766 (URN)91-554-5798-3 (ISBN)
Public defence
2003-12-19, Hedstrandsalen, Uppsala University Hospital entrance 70, Uppsala, 13:15
Opponent
Supervisors
Available from: 2003-11-19 Created: 2003-11-19Bibliographically approved

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