A new model of electrically evoked pain and hyperalgesia in human skin: the effects of intravenous alfentanil, S(+)-ketamine, and lidocaine.
BACKGROUND
The authors used the analgesics alfentanil, S(+)-ketamine, and systemic lidocaine to examine a new human model of experimental pain and hyperalgesia.


METHODS
Transcutaneous electrical stimulation at a high current density (5 Hz, 67.5+/-6.6 mA) was used to provoke acute pain (numeric rating scale, 5 of 10), stable areas of secondary mechanical hyperalgesia to pin prick (43.6+/-32.1 cm2), and light touch (27.5+/-16.2 cm2) for 2 h. Alfentanil, S(+)-ketamine, and lidocaine were applied for 20 min in a double-blind, placebo-controlled, crossover design in 12 subjects using target controlled infusions.


RESULTS
In the placebo session, pain ratings and areas of hyperalgesia were stable during the stimulation period, which facilitated the assessment of analgesic effects. Alfentanil effectively inhibited electrically evoked pain and reduced pin prick hyperalgesia and allodynia during its infusion. S(+)-ketamine-induced inhibition of secondary hyperalgesia was more pronounced and lasted for the whole experimental protocol. Therapeutic levels of systemic lidocaine showed only marginal analgesic effects, but lasting antihyperalgesic effects.


CONCLUSIONS
A new model of electrically induced pain and hyperalgesia was established, which enabled assessment of the time course of analgesic and antihyperalgesic effects with high temporal resolution and minimum tissue damage and which was further validated by use of common intravenous anesthetics.
Koppert
W
W
Department of Anesthesiology, University of Erlangen-Nuremberg, Germany. koppert@kfa.imed.uni-erlangen.de
Dern
S K
SK
Sittl
R
R
Albrecht
S
S
Schüttler
J
J
Schmelz
M
M
D000328:Adult; D015760:Alfentanil / Q000494:pharmacology; D000700:Analgesics / Q000494:pharmacology*; D000701:Analgesics, Opioid / Q000494:pharmacology; D000778:Anesthetics, Dissociative / Q000494:pharmacology; D000779:Anesthetics, Local / Q000494:pharmacology; D001369:Axons / Q000502:physiology; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000523:psychology*; D007649:Ketamine / Q000494:pharmacology; D008012:Lidocaine / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010147:Pain Measurement / Q000187:drug effects*; D012018:Reflex / Q000502:physiology; D012879:Skin Physiological Phenomena
D000700:Analgesics; D000701:Analgesics, Opioid; D000778:Anesthetics, Dissociative; D000779:Anesthetics, Local; D015760:Alfentanil; D007649:Ketamine; D008012:Lidocaine