Central analgesic effect of ketoprofen in humans: electrophysiological evidence for a supraspinal mechanism in a double-blind and cross-over study.
The aims of this study were: (1) to test the hypothesis of a central analgesic effect of the aspirin-like drug ketoprofen and (2) to attempt to differentiate between a spinal and a supraspinal mechanism in this possible central action. The threshold of the nociceptive flexion reflex from the biceps femoris muscle elicited by sural nerve stimulation was studied before and after a double-blind, cross-over and randomized intravenous injection of ketoprofen (100 mg in 5 ml saline) and saline (5 ml) in 2 groups of volunteers. The first one was composed of 10 normal subjects while the second consisted of 8 paraplegic patients with complete spinal section of traumatic origin. In normal subjects, ketoprofen injection resulted in a rapid and significant increase (+68%) of the threshold of the nociceptive reflex, while saline injection produced a slow increase of only 17% of this threshold. In contrast, in paraplegic patients, neither ketoprofen nor saline produced any significant change in the nociceptive reflex threshold. A supraspinal involvement in the central analgesic effect of this drug is discussed.
Lab. de Neurophysiologie, Faculté de Médicine Pitié-Salpêtriére, 75013 ParisFrance INSERM U. 215, Hôpital R. Poincaré, 92380 GarchesFrance Specia, Rhône Poulenc, 75013 ParisFrance.
Jean-Claude
JC
Wilier
Thomas
T
De Broucker
Bernard
B
Bussel
Agnés
A
Roby-Brami
Jean-Marie
JM
Harrewyn
D000328:Adult; D000700:Analgesics / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects / Q000503:physiopathology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007660:Ketoprofen / Q000627:therapeutic use*; D008297:Male; D010146:Pain / Q000188:drug therapy* / Q000503:physiopathology; D010264:Paraplegia / Q000503:physiopathology*; D010666:Phenylpropionates / Q000627:therapeutic use*
D000700:Analgesics; D010666:Phenylpropionates; D007660:Ketoprofen