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BJA Advance Access originally published online on April 21, 2008
British Journal of Anaesthesia 2008 100(6):827-833; doi:10.1093/bja/aen082
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Lornoxicam characteristically modulates cerebral pain-processing in human volunteers: a functional magnetic resonance imaging study

I. H. Lorenz1, K. Egger2,*, H. Schubert3, C. Schnürer4, W. Tiefenthaler1, M. Hohlrieder1, M. F. Schocke2, C. Kremser2, R. Esterhammer2, A. Ischebeck5, P. L. Moser6 and C. Kolbitsch1

1 Department of Anaesthesia and Intensive Care Medicine
2 Department of Radiology
3 Department of Trauma Surgery and Sports Medicine
4 Department of Orthopaedic Surgery
5 Department of Neurology
6 Department of Pathology, Innsbruck Medical University (MUI), A-6020 Innsbruck, Anichstrasse 35, Austria

* Corresponding author. E-mail: karl.egger{at}i-med.ac.at

Background: Lornoxicam like other non-steroidal anti-inflammatory drugs (NSAIDs) is widely used for postoperative pain therapy. Evaluation of the effect of lornoxicam on cerebral processing of surgical pain was thus the aim of the present functional magnetic resonance imaging (fMRI) study.

Methods: An fMRI-compatible pain model that mimics surgical pain was used to induce pain rated 4–5 on a visual analogue scale (VAS) at the anterior margin of the right tibia in volunteers (n=22) after i.v. administration of saline (n=11) or lornoxicam (0.1 mg kg–1) (n=11).

Results: Lornoxicam, which significantly reduced pain sensation [VAS: mean (SD) 4.6 (0.7) vs 1.2 (1.5)], completely suppressed pain-induced activation in the SII/operculum, anterior cingulate cortex, insula, parietal (inferior), prefrontal (inferior, medial), temporal (inferior, medial/superior) lobe, cerebellum, and contralateral (e.g. left-sided) postcentral gyrus (SI). Only the hippocampus and the contralateral superior parietal lobe (BA 7) were activated.

Conclusions: As compared with saline, lornoxicam typically suppressed pain-induced brain activation in all regions except the hippocampus. Furthermore, de novo activation was found in the contralateral, superior parietal lobe (BA 7).

Keywords: brain, magnetic resonance imaging; brain, metabolism; brain, oxygen consumption; pain, experimental


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