TY - JOUR

T1 - Differential effect of opioids in patients with chronic pancreatitis

T2 - an experimental pain study

AU - Staahl, Camilla

AU - Dimcevski, Georg

AU - Andersen, Søren Due

AU - Thorsgaard, Niels

AU - Christrup, Lona L

AU - Arendt-Nielsen, Lars

AU - Drewes, Asbjørn Mohr

N1 - Keywords: Adult; Analgesics, Opioid; Analysis of Variance; Cross-Over Studies; Denmark; Double-Blind Method; Electric Stimulation; Esophagus; Female; Heat; Humans; Male; Middle Aged; Morphine; Muscle, Skeletal; Oxycodone; Pain; Pain Measurement; Pain Threshold; Pancreatitis, Chronic; Reproducibility of Results; Skin; Stress, Mechanical; Treatment Outcome

PY - 2007

Y1 - 2007

N2 - OBJECTIVE: Animal experiments and clinical observations have indicated a different working profile of oxycodone compared to morphine, and it has previously been shown that oxycodone attenuates visceral pain better than morphine. The objective of this study was to test the effects of oxycodone and morphine on experimental pain in patients with pain caused by chronic pancreatitis. MATERIAL AND METHODS: Ten patients took part in this blinded, cross-over study. The analgesic effects of morphine (30 mg, oral), oxycodone (15 mg, oral) and placebo were tested against multimodal (mechanical, thermal and electrical) experimental pain in the skin, muscles and oesophagus. Pain was assessed at baseline and 30, 60 and 90 min after drug administration. RESULTS: In the skin and muscles, oxycodone was more effective than placebo and morphine on mechanically (skin: F=12.4, p<0.001, muscle: F=11.0, p<0.001) and thermally (skin: F=8.5, p<0.001) evoked pain. In oesophageal heat pain, the effect of morphine was equal to that of placebo, while oxycodone attenuated pain better than both morphine and placebo (F=9.5, p<0.001). Both morphine and oxycodone were more effective in attenuating mechanical pain in the oesophagus than placebo (F=8.6, p<0.001). After electrical stimulation no differences were seen between the opioids and placebo in any tissue studied. CONCLUSIONS: Oxycodone was a stronger analgesic than morphine in several pain modalities in the skin, muscle and oesophagus.

AB - OBJECTIVE: Animal experiments and clinical observations have indicated a different working profile of oxycodone compared to morphine, and it has previously been shown that oxycodone attenuates visceral pain better than morphine. The objective of this study was to test the effects of oxycodone and morphine on experimental pain in patients with pain caused by chronic pancreatitis. MATERIAL AND METHODS: Ten patients took part in this blinded, cross-over study. The analgesic effects of morphine (30 mg, oral), oxycodone (15 mg, oral) and placebo were tested against multimodal (mechanical, thermal and electrical) experimental pain in the skin, muscles and oesophagus. Pain was assessed at baseline and 30, 60 and 90 min after drug administration. RESULTS: In the skin and muscles, oxycodone was more effective than placebo and morphine on mechanically (skin: F=12.4, p<0.001, muscle: F=11.0, p<0.001) and thermally (skin: F=8.5, p<0.001) evoked pain. In oesophageal heat pain, the effect of morphine was equal to that of placebo, while oxycodone attenuated pain better than both morphine and placebo (F=9.5, p<0.001). Both morphine and oxycodone were more effective in attenuating mechanical pain in the oesophagus than placebo (F=8.6, p<0.001). After electrical stimulation no differences were seen between the opioids and placebo in any tissue studied. CONCLUSIONS: Oxycodone was a stronger analgesic than morphine in several pain modalities in the skin, muscle and oesophagus.

KW - Former Faculty of Pharmaceutical Sciences

U2 - 10.1080/00365520601014414

DO - 10.1080/00365520601014414

M3 - Journal article

C2 - 17354119

VL - 42

SP - 383

EP - 390

JO - Scandinavian Journal of Gastroenterology

JF - Scandinavian Journal of Gastroenterology

SN - 0036-5521

IS - 3

ER -