title: Response of neuropathic trigeminal pain to the combination of low-dose nalbuphine plus naloxone in humans.
abstract: We report on the response of medically refractory neuropathic trigeminal pain in three patients to intravenous administration of a combination of the kappa-partial agonist opioid nalbuphine and the opioid antagonist naloxone. Each of the three patients had developed a painful peripheral neuropathy as a complication of chemical or mechanical injury to the trigeminal nerve. Each patient had been tried on a number of analgesics, including mu-opioids, and had not gained relief or was not able to tolerate side effects of the medications. Pain intensity was measured for 3 h following drug administration using a 10 cm visual analog scale. All three patients reported marked decrease in pain following administration of the nalbuphine and naloxone combination. These findings suggest a novel approach to the management for neuropathic pain.
authors.affiliation: Department of Oral and Maxillofacial Surgery, C-522 (Box 0440), University of California at San Francisco, 521 Parnassus Avenue, San Francisco, CA 94143-0440, USA.
authors.forename: Brian L
authors.initials: BL
authors.lastname: Schmidt
authors.forename: Robert W
authors.initials: RW
authors.lastname: Gear
authors.forename: Jon D
authors.initials: JD
authors.lastname: Levine
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D009266:Nalbuphine / Q000627:therapeutic use*; D009270:Naloxone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D010147:Pain Measurement / Q000187:drug effects; D013997:Time Factors; D014277:Trigeminal Neuralgia / Q000188:drug therapy*
chemical_list: D000701:Analgesics, Opioid; D004338:Drug Combinations; D009292:Narcotic Antagonists; D009270:Naloxone; D009266:Nalbuphine