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British Journal of Anaesthesia, 1994, Vol. 73, No. 3 326-330
© 1994 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

Ondansetron does not inhibit the analgesic effect of alfentanil

S. PETERSEN-FELIX, MD, L. ARENDT-NIELSEN, PHD, P. BAK, MSCEE, P. BJERRING, MD, PHD, H. BREIVIK, MD, PHD, P. SVENSSON, DDS and A. M. ZBINDEN, MD, PHD

Department of Anaesthesiology and Intensive Care, University Hospital of Berne Switzerland
Department of Medical Informatics, University of Aalborg Denmark
Department of Dermatology, University Hospital of Aarhus Denmark
Department of Anaesthesiology, Rikshospitalet, University of Oslo Norway
Royal Dental College Aarhus, Denmark

Address for correspondence: Institut für Anästhesie und Intensivbehandlung, Inselspital, CH 3010 Berne, Switzerland

5-Hydroxytryptamine (5-HT) causes antinociception via presynaptic 5-HT3 (5-HT subtype 3) receptors on primary afferent nociceptive neurones in the spinal cord dorsal horn. Therefore, ondansetron (a 5-HT3 receptor antagonist) may increase the perception of a noxious stimulus or decrease the effects of concurrently administered antinociceptive drugs. Using a randomized, doubleblind, crossover study design, we have tested this hypothesis in eight healthy volunteers who, on three different days, received either ondansetron and placebo, ondansetron and alfentanil or placebo and alfentanil. Experimental pain was induced with heat, cold, mechanical pressure and electrical stimulation. Ondansetron alone did not change the response to any of the experimental tests, but alfentanil and the combination ondansetron- alfentanil significantly changed the response compared with ondansetron alone. There was no difference between alfentanil alone and the combination ondansetron-alfentanil. We conclude that ondansetron does not change the response to pressure, heat, cold or electrical nociceptive stimuli or antagonize the analgesic effect of alfentanil.


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