title: Different lipid profiles as constituencies of liquid formula diets do not influence pain perception and the efficacy of opioids in a human model of acute pain and hyperalgesia.
abstract: Nutritional support and pain control by medication are often used concomitantly, but interactions are hardly investigated. A randomised, double-blind, cross-over study in ten right-handed volunteers was performed evaluating the influence of cholecystokinin (CCK)-excretion on the perception of pain in a standardised model. CCK-excretion was induced by a liquid formula diet with either long- or medium-chain triglycerides (LCT, MCT). Plasma samples were drawn over a 60 min period in 15-min intervals and CCK and somatostatin (SMS) were measured by radioimmunoassay (RIA). Gastric emptying was evaluated by C-13-breath testing. Transcutaneous electrical stimulation at a high current density (5 Hz, 70.1+/-5.8 mA) was used to provoke acute pain and stable areas of secondary mechanical hyperalgesia and pinprick allodynia for 2 h. Ongoing pain ratings as well as extension of pinprick-hyperalgesia and allodynia were compared between both liquid formula diets. In a second series of experiments, alfentanil (4.1+/-0.5 mg) was administered for 90 min using target-controlled infusions and measurements were performed as stated above. Oral administration of LCT as well as MCT may lead to different CCK blood levels, but we found no evidence for CCK-induced effects on pain sensation, touch-evoked allodynia, secondary hyperalgesia or morphine-induced anti-nociception in humans. In our studies, liquid formula diets did not influence acute pain perception or the efficacy of opioids in a human model of pain.
authors.affiliation: Department of Anesthesiology, University of Erlangen, 91054 Erlangen, Germany Department of Medicine I, University of Erlangen, 91054 Erlangen, Germany Department of Anesthesiology, University Heidelberg, 61087 Mannheim, Germany.
authors.forename: R I
authors.initials: RI
authors.lastname: Pahl
authors.forename: W
authors.initials: W
authors.lastname: Koppert
authors.forename: C
authors.initials: C
authors.lastname: Enk
authors.forename: R
authors.initials: R
authors.lastname: Sittl
authors.forename: S
authors.initials: S
authors.lastname: Mühldorfer
authors.forename: G E
authors.initials: GE
authors.lastname: Hahn
authors.forename: M
authors.initials: M
authors.lastname: Schmelz
authors.forename: D
authors.initials: D
authors.lastname: Schwab
mesh_terms: D000208:Acute Disease; D000328:Adult; D000701:Analgesics, Opioid / Q000494:pharmacology / Q000627:therapeutic use*; D000704:Analysis of Variance; D002766:Cholecystokinin / Q000097:blood; D018592:Cross-Over Studies; D004041:Dietary Fats / Q000494:pharmacology* / Q000627:therapeutic use; D004311:Double-Blind Method; D005526:Food, Formulated; D006801:Humans; D006930:Hyperalgesia / Q000097:blood / Q000188:drug therapy*; D008297:Male; D010146:Pain / Q000097:blood / Q000188:drug therapy*; D010147:Pain Measurement / Q000187:drug effects*
chemical_list: D000701:Analgesics, Opioid; D004041:Dietary Fats; D002766:Cholecystokinin