British Journal of Anaesthesia, Vol 84, Issue 2 155-162, Copyright © 2000 by Oxford University Press
H Gottrup, PO Hansen, L Arendt-Nielsen and TS Jensen
We have examined the effect of systemic administration of ketamine and
lidocaine on brush-evoked (dynamic) pain and punctate-evoked (static)
hyperalgesia induced by capsaicin. In a randomized, double-blind,
placebo-controlled, crossover study, we studied 12 volunteers in three
experiments. Capsaicin 100 micrograms was injected intradermally on the
volar forearm followed by an i.v. infusion of ketamine (bolus 0.1 mg kg- 1
over 10 min followed by infusion of 7 micrograms kg-1 min-1), lidocaine 5
mg kg-1 or saline for 50 min. Infusion started 15 min after injection of
capsaicin. The following were measured: spontaneous pain, pain evoked by
punctate and brush stimuli (VAS), and areas of brush- evoked and
punctate-evoked hyperalgesia. Ketamine reduced both the area of
brush-evoked and punctate-evoked hyperalgesia significantly and it tended
to reduce brush-evoked pain. Lidocaine reduced the area of punctate-evoked
hyperalgesia significantly. It tended to reduce VAS scores of spontaneous
pain but had no effect on evoked pain. The differential effects of ketamine
and lidocaine on static and dynamic hyperalgesia suggest that the two types
of hyperalgesia are mediated by separate mechanisms and have a distinct
pharmacology.
ARTICLES
Differential effects of systemically administered ketamine and lidocaine on dynamic and static hyperalgesia induced by intradermal capsaicin in humans
Department of Neurology, University Hospital of Aarhus, Denmark.
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