title: Effect of intravenous tropisetron on modulation of pain and central hypersensitivity in chronic low back pain patients.
abstract: The activation of 5-hydroxytryptamine-3 (5-HT-3) receptors in spinal cord can enhance intrinsic spinal mechanisms of central hypersensitivity, possibly leading to exaggerated pain responses. Clinical studies suggest that 5-HT-3 receptor antagonists may have an analgesic effect. This randomized, double-blind, placebo-controlled crossover study tested the hypothesis that the 5-HT-3 receptor antagonist tropisetron attenuates pain and central hypersensitivity in patients with chronic low back pain. Thirty patients with chronic low back pain, 15 of whom were women (aged 53 ± 14 years) and 15 men (aged 48 ± 14 years), were studied. A single intravenous injection of 0.9% saline solution, tropisetron 2mg, and tropisetron 5mg was administrated in 3 different sessions, in a double-blind crossover manner. The main outcome was the visual analogue scale (VAS) score of spontaneous low back pain before, and 15, 30, 60, and 90 minutes after drug administration. Secondary outcomes were nociceptive withdrawal reflexes to single and repeated electrical stimulation, area of reflex receptive fields, pressure pain detection and tolerance thresholds, conditioned pain modulation, and area of clinical pain. The data were analyzed by analysis of variance and panel multiple regressions. All 3 treatments reduced VAS scores. However, there was no statistically significant difference between tropisetron and placebo in VAS scores. Compared to placebo, tropisetron produced a statistically significant increase in pain threshold after single electrical stimulation, but no difference in all other secondary outcomes was found. A single-dose intravenous administration of tropisetron in patients with chronic low back pain had no significant specific effect on intensity of pain and most parameters of central hypersensitivity.
authors.affiliation: University Department of Anaesthesiology and Pain Therapy, Bern University Hospital, Inselspital, Bern 3010, Switzerland Department of Financial and Management Studies, School of Oriental and African Studies, University of London, London, UK Department of Economics and Institutions, University of Rome Tor Vergata, Rome, Italy Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark Department of Pharmacology, University College London, London, UK.
authors.forename: Alban Y
authors.initials: AY
authors.lastname: Neziri
authors.forename: Martina
authors.initials: M
authors.lastname: Dickenmann
authors.forename: Pasquale
authors.initials: P
authors.lastname: Scaramozzino
authors.forename: Ole K
authors.initials: OK
authors.lastname: Andersen
authors.forename: Lars
authors.initials: L
authors.lastname: Arendt-Nielsen
authors.forename: Anthony H
authors.initials: AH
authors.lastname: Dickenson
authors.forename: Michele
authors.initials: M
authors.lastname: Curatolo
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000188:drug therapy* / Q000503:physiopathology*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000188:drug therapy* / Q000503:physiopathology*; D007211:Indoles / Q000008:administration & dosage*; D017116:Low Back Pain / Q000188:drug therapy* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011930:Reaction Time / Q000187:drug effects / Q000502:physiology; D058831:Serotonin 5-HT3 Receptor Antagonists / Q000008:administration & dosage*; D016896:Treatment Outcome; D000077526:Tropisetron; D055815:Young Adult
chemical_list: D007211:Indoles; D010919:Placebos; D058831:Serotonin 5-HT3 Receptor Antagonists; D000077526:Tropisetron
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