title: Remifentanil inhibits muscular more than cutaneous pain in humans.
abstract: In experimental studies, drug-induced analgesia is usually assessed by cutaneous stimulation. If analgesics act differently on cutaneous and deep nociception, the results of these studies may not be entirely applicable to clinical pain involving deep structures. We tested the hypothesis that opioids have different abilities to inhibit cutaneous and muscular pain. Either the opioid remifentanil or placebo was infused in 12 healthy volunteers in a cross-over fashion. Repeated electrical stimulation (five impulses at 2 Hz) was applied to both skin and muscle. Pain thresholds were recorded. Remifentanil caused a higher increase in the muscular pain thresholds than in the cutaneous pain thresholds (P = 0.035). We conclude that opioids inhibit muscular pain more strongly than cutaneous pain in humans.
authors.affiliation: Department of Anaesthesiology, University Hospital of Bern, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Curatolo
authors.forename: S
authors.initials: S
authors.lastname: Petersen-Felix
authors.forename: A
authors.initials: A
authors.lastname: Gerber
authors.forename: L
authors.initials: L
authors.lastname: Arendt-Nielsen
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000294:innervation*; D009928:Organ Specificity; D010146:Pain / Q000517:prevention & control*; D017288:Pain Threshold / Q000187:drug effects*; D010880:Piperidines / Q000627:therapeutic use*; D000077208:Remifentanil; D012867:Skin / Q000294:innervation*
chemical_list: D000701:Analgesics, Opioid; D010880:Piperidines; D000077208:Remifentanil