The Effect of Intrathecal Injection of Dextromethorphan on the Experimental Neuropathic Pain Model

Fahmi, Achmad; Aji, Yunus Kuntawi; Aprianto, Dirga Rachmad; Wido, Akbar; Asadullah, Asadullah; Roufi, Nurkholis; Indiastuti, Danti Nur; Subianto, Heri; Turchan, Agus

doi:10.5812/aapm.114318

Cited by 5 publications

(3 citation statements)

References 43 publications

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“…The International Diabetes Federation estimates the global population of diabetes patients to reach 366 million by 2030. Of the complications, peripheral neuropathy is the most common and 20% -30% of patients with it develop diabetic peripheral neuropathic pain (DPNP) (38,39). Treatment can be challenging, and mirogabalin has been shown to provide benefit (40)(41)(42)(43).…”

Section: Diabetic Peripheral Neuropathic Painmentioning

confidence: 99%

Mirogabalin as a Novel Gabapentinoid for the Treatment of Chronic Pain Conditions: An Analysis of Current Evidence

et al. 2021

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: Neuropathic pain has presented a challenge for physicians to treat and often requires a multimodal approach with both pharmacologic and lifestyle interventions. Mirogabalin, a potent, selective ligand of the α2δ-1 and α2δ-2 subunits of voltage-gated calcium channels (VGCCs), provides analgesia by inhibiting neurotransmitter release at the presynaptic end of the neuron. Mirogabalin offers more sustained analgesia than its gabapentinoid counterparts in addition to a wider safety margin for adverse events. Recent clinical trials of mirogabalin have demonstrated both efficacy and tolerability of the drug for the treatment of diabetic peripheral neuropathic pain and postherpetic neuralgia, leading to its approval in Japan. While still not yet FDA approved, mirogabalin is still in its infancy and offers potential into the treatment of neuropathic pain and its associated comorbidities.

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Section: Diabetic Peripheral Neuropathic Painmentioning

confidence: 99%

Mirogabalin as a Novel Gabapentinoid for the Treatment of Chronic Pain Conditions: An Analysis of Current Evidence

et al. 2021

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“…However, it is also likely that additional pathways are involved. For example, recent studies have used nerve ligation animal models to show that dextromethorphan-mediated improvements in hyperalgesia may be related to the inhibition of glucocorticoid receptor-mediated neuroinflammation [ 21 ] and decreased expression of pTyr1336NR2B receptors [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

A double-blinded, placebo-controlled, randomized study to evaluate the efficacy of perioperative dextromethorphan compared to placebo for the treatment of postoperative pain: a study protocol

Jones

Piple

Yan

et al. 2023

Trials

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Background Pain management is a critical component of comprehensive postsurgical care, as it influences patient safety and outcomes, and inadequate control has been associated with the development of chronic pain syndromes. Despite recent improvements, the management of postoperative pain following total knee arthroplasty (TKA) remains a challenge. The use of opioid-sparing, multimodal analgesic regimens has broad support, but there is a paucity of high-quality evidence regarding optimal postoperative protocols and novel approaches are needed. Dextromethorphan stands out among both well-studied and emerging pharmacological adjuncts for postoperative pain due its robust safety profile and unique pharmacology. The purpose of this study is to evaluate the efficacy of multi-dose dextromethorphan for postoperative pain control following TKA. Methods This is a single-center, multi-dose, randomized, double-blinded, placebo-controlled trial. A total of 160 participants will be randomized 1:1 to receive either 60 mg oral dextromethorphan hydrobromide preoperatively, as well as 30 mg 8 h and 16 h postoperatively, or matching placebo. Outcome data will be obtained at baseline, during the first 48 h, and the first two follow-up visits. The primary outcome measure will be total opioid consumption at 24 h postoperatively. Secondary outcomes related to pain, function, and quality of life will be evaluated using standard pain scales, the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS, JR) questionnaire, the Patient-Reported Outcomes Measurement Information System (PROMIS-29) questionnaire, and clinical anchors. Discussion This study has a number of strengths including adequate power, a randomized controlled design, and an evidence-based dosing schedule. As such, it will provide the most robust evidence to date on dextromethorphan utilization for postoperative pain control following TKA. Limitations include not obtaining serum samples for pharmacokinetic analysis and the single-center study design. Trial registration This trial has been registered on the National Institute of Health’s ClinicalTrials.gov (NCT number: NCT05278494). Registered on March 14, 2022.

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“…Neuropathic pain originates from pathophysiological defects of the peripheral or central nervous system ( 1 , 2 ). Several animal models were introduced to investigate the pathological and physiological mechanisms of neuropathic pain.…”

Section: Introductionmentioning

confidence: 99%

A Pusher and a Clip Applied to Hind Paws Under Isoflurane Sedation to Evaluate Neuropathic Pain in a CCI Model

Nobuhara

Ito²,

Nakagawa³

et al. 2021

Anesth Pain Med

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: Rodent behavior assessments have been developed to evaluate pain. However, their fidgety activity and reactivity to human contact make it hard to activate animals in a consistent manner and get uniform and trustworthy responses. The present study was performed on prairie voles (aged 8 weeks). Sham (7 male prairie voles) and chronic constriction injury (CCI) (8 male prairie voles) rodents were investigated before surgery and four and seven days later. Each animal was assessed for nociceptive behavior. Pressure and mechanical threshold tests were conducted by the application of three different pushers to the center of hind paws and arterial clips to the toes while sedated with isoflurane. The CCI affected right lower extremity prominently increased nociceptive behavior scores four and seven days after the experiment, and the CCI affected right hind paw prominently decreased pressure and mechanical threshold tests four and seven days after the experiment . The pressure and mechanical thresholds were relevant to the scorings of nociceptive behavior in CCI model animals.

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The Effect of Intrathecal Injection of Dextromethorphan on the Experimental Neuropathic Pain Model

Cited by 5 publications

References 43 publications

Mirogabalin as a Novel Gabapentinoid for the Treatment of Chronic Pain Conditions: An Analysis of Current Evidence

Mirogabalin as a Novel Gabapentinoid for the Treatment of Chronic Pain Conditions: An Analysis of Current Evidence

A double-blinded, placebo-controlled, randomized study to evaluate the efficacy of perioperative dextromethorphan compared to placebo for the treatment of postoperative pain: a study protocol

A Pusher and a Clip Applied to Hind Paws Under Isoflurane Sedation to Evaluate Neuropathic Pain in a CCI Model

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