Role of spinal noradrenergic system in transmission of pain in patients with spinal cord injury.
15 patients with deafferentation pain due to spinal cord injury were investigated for a spinal mechanism of pain transmission. Epidural morphine 5 mg in 5 ml of water had an analgesic effect in 5 patients, 3 of whom also had pain relief with epidural clonidine. Epidural clonidine 150 micrograms in 5 ml of saline had an analgesic effect in 7 patients who did not respond to epidural morphine. Neither epidural morphine nor clonidine was effective in the other 3 patients, 2 of whom obtained relief with epidural buprenorphine 0.3 mg in 5 ml of saline. 1 patient did not find relief with any of the injections. These data suggest that a spinal noradrenergic system may be as important as the opioid system in the transmission of pain in patients with spinal cord injury.
D000328:Adult; D000368:Aged; D002490:Central Nervous System / Q000503:physiopathology*; D003000:Clonidine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007268:Injections, Epidural; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D010146:Pain / Q000188:drug therapy / Q000503:physiopathology*; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D009435:Synaptic Transmission
D009020:Morphine; D003000:Clonidine