J. Lillesø, N.A. Hammer, J.L. Pedersen, H. Kehlet

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Effect of peripheral morphine in a human model of acute inflammatory pain J. Lillesø, N.A. Hammer, J.L. Pedersen, H. Kehlet British Journal of Anaesthesia Volume 85, Issue 2, Pages 228-232 (August 2000) DOI: 10.1093/bja/85.2.228 Copyright © 2000 British Journal of Anaesthesia Terms and Conditions

Fig 1 Pain during burn (47°C, 7 min). Verbal descriptors were added to the VAS at 2 mm (weak pain), 8 mm (mild pain), 18 mm (moderate pain), 39 mm (intense pain) and 74 mm (very intense pain). The pain response to the burn was not significantly altered by either systemic or local morphine treatment. British Journal of Anaesthesia 2000 85, 228-232DOI: (10.1093/bja/85.2.228) Copyright © 2000 British Journal of Anaesthesia Terms and Conditions

Fig 2 Mechanical pain detection thresholds (medians, a) and mechanical pain in the burned area (medians, b). Neither the pain threshold nor the suprathreshold pain response was significantly altered by local morphine compared with systemic morphine or placebo. For illustrative reasons (a) does not show systemic treatment, due to identical line plots of local and systemic treatment. British Journal of Anaesthesia 2000 85, 228-232DOI: (10.1093/bja/85.2.228) Copyright © 2000 British Journal of Anaesthesia Terms and Conditions

Fig 3 Area of secondary hyperalgesia (medians, a) and mechanical pain in the secondary hyperalgesic area (medians, b). Burns treated with local morphine developed larger areas of hyperalgesia than burns treated with systemic morphine 0–2 h after the burn injury (P=0.03). Also after naloxone injection, burns treated with local morphine showed larger areas of secondary hyperalgesia than burns treated with systemic morphine or placebo (P<0.04). Pain response to mechanical stimuli in the area of secondary hyperalgesia showed no significant differences between local, systemic or placebo treatment. British Journal of Anaesthesia 2000 85, 228-232DOI: (10.1093/bja/85.2.228) Copyright © 2000 British Journal of Anaesthesia Terms and Conditions

Fig 4 Pain response to a heat stimulus of 45°C (medians, a) and heat pain thresholds (means, b). The pain during the brief (5 s) heat stimuli was not reduced by local morphine, nor was the heat pain threshold significantly increased by local morphine compared with systemic morphine or placebo. British Journal of Anaesthesia 2000 85, 228-232DOI: (10.1093/bja/85.2.228) Copyright © 2000 British Journal of Anaesthesia Terms and Conditions

Fig 5 Warm detection thresholds (means, a) and cold detection thresholds (medians, b). Neither warm nor cold detection showed significant differences between treatments 0–2 h after the burn injury. After naloxone injections both warm and cold detection thresholds were significantly higher with systemic morphine compared with placebo (P=0.03). None of the other treatments differed significantly. British Journal of Anaesthesia 2000 85, 228-232DOI: (10.1093/bja/85.2.228) Copyright © 2000 British Journal of Anaesthesia Terms and Conditions