Keine Wirkung bei topischer Applikation von Morphin- und Buprenorphingel im Sonnenbrandmodell

Draxler, Julia; Schuch, M.; Paul, Anna; Sycha, Thomas; Valenta, Claudia; Likar, Rudolf; Gustorff, Burkhard

doi:10.1007/s00482-008-0660-x

Cited by 4 publications

(1 citation statement)

References 9 publications

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“…In a randomized controlled trial, topical morphine sulfate was found not to be as effective when used for the pain associated with superficial burns as when used for the pain associated with chronic inflammatory wounds [5]. It did not relieve pain either during topical photodynamic therapy or in sunburn wounds [6]. Neuropathic cancer pain does not respond to topical morphine [7].…”

Section: Introductionmentioning

confidence: 99%

Topical morphine for treatment of cancer-related painful mucosal and cutaneous lesions: a double-blind, placebo-controlled cross-over clinical trial

Ciałkowska-Rysz¹,

Dzierżanowski²

2019

aoms

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Topical morphine for treatment of cancer-related painful mucosal and cutaneous lesions: a double-blind, placebo-controlled cross-over clinical trial Aleksandra Ciałkowska-Rysz, Tomasz Dzierżanowski A b s t r a c t Introduction: Painful mucosal and cutaneous lesions are often less responsive or even refractory to systemic opioid analgesics. There is evidence suggesting that the effectiveness of topical morphine be restricted to inflammatory pain. The studied groups were small and the observation period relatively short. The aim of this study was to assess the effectiveness and safety of topical morphine for pain related to mucosal lesions and skin ulcers. Material and methods: The study was a 14-day randomized placebo-controlled cross-over trial (RCT) with a 28-day follow-up open phase (OP). The trial was conducted in adult patients with localized cancer-related pain and treated with systemic opioids in an oncology center or home hospice. The patients administered 0.2% gel on the mucosal lesion or 0.2% ointment on the skin lesion by themselves, without restrictions regarding the number of doses per day. The primary measurements were mean pain intensity (MPI) and mean pain relief (MPR) on the numeric rating scale (NRS 0-10), and ITT analysis was performed. Results: Thirty-five patients were randomized to the RCT, and all of them completed 14-day observation. The MPI before the treatment was NRS 5.9 and decreased to 2.5 after morphine (p < 0.0001 vs. placebo). The MPR was 57% after morphine, and 77% of the patients using topical morphine obtained clinically significant (at least 50% of the starting value) pain relief, statistically different from placebo. The analgesic effect was sustained over the 28-day OP period (p = 0.00001). There were only 2 cases of moderate pruritus, and no other side effects were reported. Conclusions: Topical morphine was found to be a fast acting, highly effective, and safe medication for mucosal and skin lesions in palliative patients, with a sustainable pain relief effect over the 28-day observation period.

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Section: Introductionmentioning

confidence: 99%

Topical morphine for treatment of cancer-related painful mucosal and cutaneous lesions: a double-blind, placebo-controlled cross-over clinical trial

Ciałkowska-Rysz¹,

Dzierżanowski²

2019

aoms

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Ultraviolet Radiation on the Skin: A Painful Experience?

Lopes

McMahon

2015

CNS Neurosci Ther

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SummaryExcessive exposure of skin to ultraviolet radiation (UVR) has dramatic clinical effects in humans, and it is a significant public health concern. Discomfort and sensory changes caused by skin sunburn are the main common features experienced by many of us, a phenomena triggered by the combination of long and short wavelengths radiation (UVA and UVB, respectively). Although the biological processes underlying UVR exposure are not fully understood, in the last few years many studies have made significant progress in characterizing sunburn at the cellular and molecular levels, making use of both humans and laboratory animal models. Here we review and reason that UVR can be used as an excellent model of sensitization and inflammation for pain research. UVR, particularly UVB, produces a controllable and sterile inflammation that causes a robust dose‐dependent hypersensitivity with minimal confounding effects. Importantly, we show that UVR animal models precisely recapitulate the sensory, cellular, and molecular changes observed in human skin, giving it great confidence as a translational model. Furthermore, in this article, we give an overview of the pharmacology underlying UVB inflammation, the latest advances in the field, and potential new targets for inflammatory pain.

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Effect of transdermal opioids in experimentally induced superficial, deep and hyperalgesic pain

Staahl

Oksche

Mansikka

et al. 2011

British J Pharmacology

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BACKGROUND AND PURPOSE Chronic pain and hyperalgesia can be difficult to treat with classical opioids acting predominately at the µ‐opioid receptor. Buprenorphine and its active metabolite are believed to act through µ‐, κ‐ and δ‐receptors and may therefore possess different analgesic and anti‐hyperalgesic effects compared with pure µ‐receptor agonists, for example, fentanyl. Here, we have compared the analgesic and anti‐hyperalgesic effects of buprenorphine and fentanyl. EXPERIMENTAL APPROACH Twenty‐two healthy volunteers were randomized to treatment with transdermal buprenorphine (20 µg·h−1, 144 h), fentanyl (25 µg·h−1, 72 h) or placebo patches in a double‐blind, cross‐over experimental pain study. The experimental pain tests (phasic pain, sensitization) involved pressure at the tibial bone, cutaneous electrical and thermal stimulation, intramuscular nerve growth factor, UVB light burn injury model and intradermal capsaicin‐induced hyperalgesia. Pain testing was carried out at baseline, 24, 48, 72 and 144 h after application of the drugs. KEY RESULTS Compared with placebo, buprenorphine, but not fentanyl, significantly attenuated pressure at the tibial bone as well as pressure pain in the primary hyperalgesic area induced by UVB light The two drugs were equipotent and better than placebo against cutaneous thermal pain stimulation), but failed to show significant analgesic effect to cutaneous electrical stimulation, nerve growth factor‐induced muscle soreness and to capsaicin‐induced hyperalgesia. CONCLUSIONS AND IMPLICATIONS Buprenorphine, but not fentanyl, showed analgesic effects against experimentally induced, bone‐associated pain and primary hyperalgesia compared with placebo. These tissue‐ and modality‐differentiated properties may reflect the variable effects of opioid drugs observed in individual patients.

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Keine Wirkung bei topischer Applikation von Morphin- und Buprenorphingel im Sonnenbrandmodell

Abstract: The topical application of opioids in this form has no effect on inflamed skin.

Cited by 4 publications

References 9 publications

Topical morphine for treatment of cancer-related painful mucosal and cutaneous lesions: a double-blind, placebo-controlled cross-over clinical trial

Topical morphine for treatment of cancer-related painful mucosal and cutaneous lesions: a double-blind, placebo-controlled cross-over clinical trial

Ultraviolet Radiation on the Skin: A Painful Experience?

Effect of transdermal opioids in experimentally induced superficial, deep and hyperalgesic pain

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