NMDA-Receptor Antagonists in Neuropathic Pain

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Presentation transcript:

NMDA-Receptor Antagonists in Neuropathic Pain Christine N Sang, MD, MPH Journal of Pain and Symptom Management Volume 19, Issue 1, Pages 21-25 (January 2000) DOI: 10.1016/S0885-3924(99)00125-6

Fig. 1 Ongoing pain plotted as percent baseline. The baseline was defined as the average of the visual analog scale (VAS) at 10 and 20 minutes. The mean pain score over the infusion period significantly decreased for both ketamine and alfentanil, compared to placebo (P < 0.01). Reproduced with permission from Nelson et al.12 Journal of Pain and Symptom Management 2000 19, 21-25DOI: (10.1016/S0885-3924(99)00125-6)

Fig. 2 Allodynia: alfentanil (n = 6, P < 0.05) but not ketamine (n = 5) showed a significant reduction in mean area of allodynia during the infusion compared to placebo. Only subjects in whom allodynia persisted to 20 minutes in both sessions of the comparison are included. Reproduced with permission from Park et al.2 Journal of Pain and Symptom Management 2000 19, 21-25DOI: (10.1016/S0885-3924(99)00125-6)

Fig. 3 Pinprick hyperalgesia: Mean area of hyperalgesia during the infusion decreased for both ketamine and alfentanil (P < 0.01). Reproduced with permission from Park et al.2 Journal of Pain and Symptom Management 2000 19, 21-25DOI: (10.1016/S0885-3924(99)00125-6)

Fig. 4 Mean weekly pain intensity during baseline and treatment periods for patients receiving dextromethorphan or placebo. Diabetic neuropathy: in the last week of the 6-week treatment period, dextromethorphan reduced pain by a mean of 24% (95% CI: 6–42%, P = 0.014) relative to the pain level at the end of placebo treatment. Postherpetic neuralgia: in the last week of the 6-week treatment period there was slightly less pain during placebo than dextromethorphan by a mean of 2% (95% CI: 10% decrease in pain to 14% increase, NS). Reproduced with permission from Nelson et al.12 Journal of Pain and Symptom Management 2000 19, 21-25DOI: (10.1016/S0885-3924(99)00125-6)