Stimulation of spinal muscarinic acetylcholine receptors (mAChRs) produces potent analgesia. Both M 2 and M 4 mAChRs are coupled to similar G proteins (G i/o family) and play a critical role in the analgesic action of mAChR agonists. To determine the relative contribution of M 2 and M 4 The cholinergic system and muscarinic acetylcholine receptors (mAChRs) in the dorsal horn of the spinal cord are important for regulation of different physiological functions including nociception. In this regard, intrathecal administration of muscarinic receptor agonists or acetylcholinesterase inhibitors produces potent analgesia in both animals and humans (Iwamoto and Marion, 1993; Yaksh, 1994, 1997;Hood et al., 1997). The analgesic effect produced by muscarinic receptor agonists or acetylcholinesterase inhibitors is blocked by the mAChR antagonist atropine (Naguib and Yaksh, 1994). Furthermore, spinal acetylcholine and mAChRs are involved in the analgesic action produced by morphine and ␣ 2 -adrenergic receptor agonists (Pan et al., 1999;Chen and Pan, 2001). It has been shown that neurons and nerve terminals expressing choline acetyltransferase and acetylcholinesterase (enzymes for acetylcholine synthesis and degradation) are located in the spinal dorsal horn (Ribeiro-da-Silva and Cuello, 1990;Wetts and Vaughn, 1994). Autoradiographic studies have demonstrated that the highest density of mAChRs in the spinal cord is distributed in the superficial laminae in both rats and humans (Yamamura et al., 1983;Villiger and Faull, 1985;Maher et al., 2001).Molecular cloning studies have revealed the existence of five molecularly distinct mAChR subtypes referred to as M 1 to M 5 (Wess, 1996;Caulfield and Birdsall, 1998). The M 1 to M 5 mAChRs are prototypical members of the superfamily of G protein-coupled receptors. The M 1 , M 3 , and M 5 receptor subtypes couple preferentially to the G q/11 protein, whereas the M 2 and M 4 receptors are preferentially coupled to G i/o proteins (Caulfield, 1993;Felder, 1995). In rodents, both the M 2 and M 4 subtypes that are coupled to the pertussis toxinsensitive G i/o proteins have been implicated in the inhibitory