Propofol at conscious sedation doses produces mild analgesia to cold pressor-induced pain in healthy volunteers

Zacny, James P.; Coalson, Dennis W.; Young, C.; Klafta, Jerome M.; Lichtor, J. Lance; Rupani, G.; Thapar, Pankaj; Apfelbaum, Jeffrey L.

doi:10.1016/0952-8180(96)00126-2

Cited by 39 publications

(28 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A possibility for the lack of sex-dependent effects for positive subjective drug effect ratings in the current analysis is the potential sex-dependent interaction of the CPT on subjective drug responses. The CPT has been shown to alter subjective drug effects, an effect that is observed during exposure to the painful stimulus, including ratings of ‘High’ and ‘Elated’ (Conley et al, 1997; Zacny et al, 1996a, b). In one study, pain-induced modulation of opioid subjective effects were specifically observed among women and not men (Zacny and Beckman, 2004).…”

Section: Discussionmentioning

confidence: 99%

Sex-dependent effects of cannabis-induced analgesia

Cooper

Haney

2016

Drug and Alcohol Dependence

View full text Add to dashboard Cite

Background Preclinical studies demonstrate that cannabinoid-mediated antinociceptive effects vary according to sex; it is unknown if these findings extend to humans. Methods This retrospective analysis compared the analgesic, subjective and physiological effects of active cannabis (3.56 - 5.60% THC) and inactive cannabis (0.00% THC) in male (N = 21) and female (N = 21) cannabis smokers under double-blind, placebo-controlled conditions. Pain response was measured using the Cold-Pressor Test (CPT). Participants immersed their hand in cold water (4°C); times to report pain (pain sensitivity) and withdraw the hand (pain tolerance) were recorded. Subjective drug ratings were also measured. Results Among men, active cannabis significantly decreased pain sensitivity relative to inactive cannabis (p < 0.01). In women, active cannabis failed to decrease pain sensitivity relative to inactive. Active cannabis increased pain tolerance in both men women immediately after smoking (p < 0.001); a trend was observed for differences between men and women (p < 0.10). Active cannabis also increased subjective ratings of cannabis associated with abuse liability (‘Take again,’ ‘Liking,’ ‘Good drug effect’), drug strength, and ‘High’ relative to inactive in both men and women (p < 0.01). Conclusions These results indicate that in cannabis smokers, men exhibit greater cannabis-induced analgesia relative to women. These sex-dependent differences are independent of cannabis-elicited subjective effects associated with abuse-liability, which were consistent between men and women. As such, sex-dependent differences in cannabis's analgesic effects are an important consideration that warrants further investigation when considering the potential therapeutic effects of cannabinoids for pain relief.

show abstract

Section: Discussionmentioning

confidence: 99%

Sex-dependent effects of cannabis-induced analgesia

Cooper

Haney

2016

Drug and Alcohol Dependence

View full text Add to dashboard Cite

show abstract

“…The participans undergoing brest, ginecologic, orthopedic, ENT, abdominal, urogenital, spine, cosmetic or eye surgery. In 7 studies the participants were volunteer and have no surgery (total 163 volunteers) , Anker-Møller et al, 1991, Zacny et al, 1996, Petersen-Felix et al, 1996, Hand et al, 2001, Frolich et al, 2005. The participants were randomly assigned to receive propofol and in control group: thiopental ; thiopental and saline (Anker-Møller et al, 1991); thiopental with halothane ; or, thiopenthal with isoflurane & Jellish et al,1995.…”

Section: Resultsmentioning

confidence: 99%

Propofol and Postoperative Pain: Systematic Review and Meta-Analysis

Hasani¹,

Jashari²,

Gashi³

et al. 2012

Pain Management - Current Issues and Opinions

View full text Add to dashboard Cite

“…Several studies of experimental pain in humans reported analgesic effects of subhypnotic doses of propofol. 17–20 Moreover, some recent clinical studies have reported that surgical patients receiving propofol anesthesia experienced reduced postoperative pain 21,22 (see also 23 ).…”

Section: Introductionmentioning

confidence: 99%

The Antinociceptive and Antihyperalgesic Effects of Topical Propofol on Dorsal Horn Neurons in the Rat

Takechi

Carstens

Klein

et al. 2013

Anesthesia &Amp; Analgesia

View full text Add to dashboard Cite

Background Propofol (2,6-diisopropylphenol) is an IV anesthetic used for general anesthesia. Recent evidence suggests that propofol-anesthetized patients experience less postoperative pain, and that propofol has analgesic properties when applied topically. We presently investigated the antinociceptive effects of topical propofol using behavioral and single-unit electrophysiological methods in rats. Methods In behavioral experiments with rats, we assessed the effect of topical hindpaw application of propofol (1–25%) on heat and mechanically evoked paw withdrawals. In electrophysiology experiments we recorded from lumbar dorsal horn wide dynamic range (WDR)-type neurons in pentobarbital-anesthetized rats. We assessed the effect of topical application of propofol to the ipsilateral hindpaw on neuronal responses elicited by noxious heat, cold and mechanical stimuli. We additionally tested if propofol blocks heat sensitization of paw withdrawals and WDR neuronal responses induced by topical application of allyl isothiocyanate (AITC; mustard oil). Results Topical application of propofol (1–25%) significantly increased the mean latency of the thermally evoked hindpaw withdrawal reflex on the treated (but not opposite) side in a concentration-dependent manner, with no effect on mechanically evoked hindpaw withdrawal thresholds. Propofol also prevented shortening of paw withdrawal latency induced by AITC. In electrophysiological experiments, topical application of 10 and 25% propofol, but not 1% propofol or vehicle (10% intralipid), to the ipsilateral hindpaw significantly attenuated the magnitude of responses of WDR neurons to noxious heating of glabrous hindpaw skin with no significant change in thermal thresholds. Maximal suppression of noxious heat-evoked responses was achieved 15-min after application followed by recovery to the pre-propofol baseline by 30 min. Responses to skin cooling or graded mechanical stimuli were not significantly affected by any concentration of propofol. Topical application of AITC enhanced the noxious heat-evoked response of dorsal horn neurons. This enhancement of heat-evoked responses was attenuated when 10% propofol was applied topically after application of AITC. Conclusions The results indicate that topical propofol inhibits responses of WDR neurons to noxious heat consistent with analgesia, and reduced AITC sensitization of WDR neurons consistent with an antihyperalgesic effect. These results are consistent with clinical studies demonstrating reduced postoperative pain in surgical patients anesthetized with propofol. The mechanism of analgesic action of topical propofol is not clear, but may involve desensitization of TRPV1 or TRPA1 receptors expressed in peripheral nociceptive nerve endings, engagement of endocannabinoids, or activation of peripheral gamma-aminobutyric acid A receptors.

show abstract

Propofol at conscious sedation doses produces mild analgesia to cold pressor-induced pain in healthy volunteers

Cited by 39 publications

References 16 publications

Sex-dependent effects of cannabis-induced analgesia

Sex-dependent effects of cannabis-induced analgesia

Propofol and Postoperative Pain: Systematic Review and Meta-Analysis

The Antinociceptive and Antihyperalgesic Effects of Topical Propofol on Dorsal Horn Neurons in the Rat

Contact Info

Product

Resources

About