title: Psychophysical and electrophysiological responses to experimental pain may be influenced by sedation: comparison of the effects of a hypnotic (propofol) and an analgesic (alfentanil).
abstract: Sedation may influence the responses of some experimental pain models used to test analgesic efficacy. In this study we compared the effects of a sedative (propofol) and analgesic (alfentanil) on: nociceptive reflex to single and repeated electrical stimulations; mechanical pressure pain; and evoked potentials elicited by nociceptive (electrical and laser) and non-nociceptive (acoustical) stimulation. We studied 12 healthy volunteers with two subanaesthetic concentrations of propofol and two analgesic concentrations of alfentanil. Both propofol and alfentanil increased the threshold for nociceptive reflex to single electrical stimulations, but only alfentanil increased the threshold for nociceptive reflex to repeated electrical stimulations. The pressure pain tolerance thresholds were increased significantly by alfentanil, whereas propofol significantly decreased the thresholds (hyperalgesia). Propofol and alfentanil induced similar reductions in the amplitudes of the evoked potentials elicited by nociceptive (electrical and laser) and non-nociceptive (acoustical) stimulation, whereas only alfentanil reduced the perceived pain to nociceptive stimulations. We have shown that sedation can influence both the psychophysical and electrophysiological responses of some experimental pain tests used to measure analgesic efficacy, and that propofol in subhypnotic doses, has no analgesic effect on painful electrical and heat stimulations, but has a hyperalgesic effect on mechanical pressure pain.
authors.affiliation: Department of Anaesthesiology and Intensive Care, University Hospital of Bern, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Petersen-Felix
authors.forename: L
authors.initials: L
authors.lastname: Arendt-Nielsen
authors.forename: P
authors.initials: P
authors.lastname: Bak
authors.forename: M
authors.initials: M
authors.lastname: Fischer
authors.forename: A M
authors.initials: AM
authors.lastname: Zbinden
mesh_terms: D000328:Adult; D015760:Alfentanil / Q000494:pharmacology*; D000701:Analgesics, Opioid / Q000494:pharmacology*; D005071:Evoked Potentials / Q000187:drug effects; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology*; D008297:Male; D009619:Nociceptors / Q000187:drug effects; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D017288:Pain Threshold / Q000187:drug effects; D011312:Pressure; D015742:Propofol / Q000494:pharmacology*; D011601:Psychophysics; D011930:Reaction Time / Q000187:drug effects
chemical_list: D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D015760:Alfentanil; D015742:Propofol