title: Assessment of the analgesic effect of remifentanil using three pain models in healthy Korean volunteers: a randomized, controlled study.
abstract: Quantitative pain assessment in human beings is useful for developing new analgesics. This study assessed the analgesic effect of remifentanil in 20 healthy Korean men using three pain models to investigate whether these models can be used in Asians. The study was a double-blind, placebo-controlled, two-way cross-over study. The subjects received intravenous remifentanil with doses starting at 0.01 μg/kg/min. and increasing by 0.01 μg/kg/min. up to 0.10 μg/kg/min. in one session; they received placebo in another session. Heat pain thresholds were assessed at dose levels of 0.02, 0.05, 0.08 and 0.10 μg/kg/min. Pressure pain threshold and tolerance and mechanical pain threshold were assessed at 0.08 μg/kg/min. Remifentanil dose-dependently increased the heat pain threshold. The differences (95% confidence interval) between remifentanil and placebo were 1.54°C (0.78, 2.31), 1.82°C (1.11, 2.54) and 2.47°C (1.55, 3.38) at 0.05, 0.08 and 0.10 μg/kg/min. remifentanil, respectively. Remifentanil conferred a significantly higher pressure pain threshold and tolerance than placebo (p = 0.0001). There was a trend of increasing mechanical pain threshold with remifentanil, although it was not statistically significant. The results suggest that heat pain and pressure pain models are valid in East Asians for assessing analgesic effects.
authors.affiliation: Department of Pharmacology and Clinical Pharmacology, Seoul National University College of Medicine and Hospital, Seoul, South Korea.
authors.forename: Tae-Eun
authors.initials: TE
authors.lastname: Kim
authors.forename: Kyu-Pyo
authors.initials: KP
authors.lastname: Kim
authors.forename: Donghoon
authors.initials: D
authors.lastname: Shin
authors.forename: Yong-Ju
authors.initials: YJ
authors.lastname: Chung
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Price
authors.forename: Prafull
authors.initials: P
authors.lastname: Mistry
authors.forename: In-Jin
authors.initials: IJ
authors.lastname: Jang
authors.forename: Kyung-Sang
authors.initials: KS
authors.lastname: Yu
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D000704:Analysis of Variance; D044466:Asian People; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D006358:Hot Temperature; D006801:Humans; D007262:Infusions, Intravenous; D016018:Least-Squares Analysis; D008297:Male; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology / Q000209:etiology / Q000503:physiopathology; D010147:Pain Measurement; D017288:Pain Threshold / Q000187:drug effects* / Q000208:ethnology; D010880:Piperidines / Q000008:administration & dosage / Q000627:therapeutic use*; D011312:Pressure; D000077208:Remifentanil; D056910:Republic of Korea / Q000208:ethnology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D010880:Piperidines; D000077208:Remifentanil