The epidural and intrathecal administration of somatotrophin-release inhibiting factor: Native and synthetic analogues

Abstract

It is well-known that morphine is the king of analgesics. It is widely used, and administered in various ways for the control of acute and chronic pain states. There are, however, certain types of pain and certain clinical conditions in which morphine cannot be used due to the risk of possible complications. These are usually pain states associated with intracranial hypertension, the presence of serious respiratory problems, the onset of major opioid tolerance, persistent vomiting, and so on. The search for "alternative analgesics" has been in progress for a decade, alternatives that could be used alone or in combination for spinal administration in the treatment of complex chronic pain states and with a low incidence of secondary effects. Today, research is carefully assessing the clinical effectiveness and the side effects of a series of drugs for spinal administration, that is, epidural or intrathecal, such as the new narcotics, alpha-2 agonists, central muscle relaxants, calcitonin, and local anesthetics. In this alternative analgesic category we have to mention the somatotrophin-release inhibiting factor (SRIF), which is an ubiquitous native hormone with widespread, predominantly inhibitory actions, and octreotide, its synthetic analogue. In this article we review the literature on the natural drug and its synthetic analogue, paying particular attention to the problems connected with intraspinal administration and analgesic properties.

A study of acromegaly-associated headache with somatostatin analgesia

“…These locations in the central nervous system have a role in pain transmission or inhibition (it can have dual effect on neurons; depending on the modality of pain signalled); therefore, somatostatin analogues would be expected to have an effect on pain (Chapman and Dickenson 1992;Dean 2001;Jung et al 2008) and pancreatic carcinoma pain, bone pain from metastatic carcinoid and hypertrophic pulmonary osteoarthropathy (Conno et al 1994;Johnson et al 1997;Dean 2001;Katai et al 2005). Epidural somatostatin was successfully implemented in analgesia of upper abdominal surgery and cancer pain (Taurà et al 1994;Beltrutti et al 2000). Intratracheal octreotide infusion was sufficient in cancer paint intraventricular could be potentially useful in patients with head and neck cancer exhibiting local nonopioid-sensitive pain (Candrina and Galli 1992;Penn et al 1992).…”

Modulation of Neuropathic Pain by a Glial-Derived Factor

“…As early as 1984, intrathecal or epidural somatostatin injections were used to provide analgesia from cancer or postoperative pain [27,28]. This effect has been mimicked by stable somatostatin analogues in humans [29,30], as well as in animals [31–34]. The analgesic role of somatostatin is consistent with its primary activity as an inhibitory peptide in the central nervous system [35,36].…”

Current Treatment Approaches With Somatostatin

“…Dog rudan ve dolaylı antineoplastik etkilerini bu yu me hormonunun salgılanmasını inhibe ederek ve insu lin ile gastrointestinal hormonların salımını du zenleyen dig er peptidleri inhibe ederek go sterdig i du şu nu lmektedir. Vapreotid'in yan etkilerinin baş ag rısı, yorgunluk, diyare, bulantı, kusma ve karın ag rısı oldug u bildirilmiştir (6,7,14,15).…”