[Calcitonin.].
A central antinociceptive effect of calcitonin has been well established in animal experiments. Owing to the lack of appropriate studies, however, a final judgement cannot be made regarding the value of calcitonin in pain therapy. Positive clinical experiences have been reported in the following cases. (1) In isolated osseous tumor pain and in pain caused by tumorous infiltration of peripheral nerve tissue or acute malignant transverse lesions of the spinal cord (with paraplegia), calcitonin can be a suitable supplement to opiate therapy. (2) In algodystrophy calcitonin can be administered in addition to physical therapy. In severe cases, however, this therapy must be supplemented or replaced by sympathetic blockade. (3) In cases of phantom limb pain calcitonin is particularly effective and can also be administered alone as an analgesic. In refractory cases there is usually stump pain of various causes in addition to phantom limb pain. For pain therapy calcitonin should only be administered intravenously in a daily dosage of 1.5-3 IU/kg body weight. If there is no initial success, treatment should not be continued. Dangerous side-effects have not been reported to date. However, dose-dependent side-effects occur frequently, which the patients often consider very distressing. The disadvantages and the "escape" phenomenon that occur during longterm use restrict the value of calcitonin as an analgesic.
Maier
C
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Schmerzsprechstunde der Zentralen Abteilung für Anaesthesie, Klinikum der Universität, Schwanenweg 21, D-2300, Kiel 1.