A brief, high-dose remifentanil infusion partially reverses neuropathic pain in a subgroup of post herpetic neuralgia patients

J Clin Neurosci. 2017 Jun:40:195-197. doi: 10.1016/j.jocn.2017.02.048. Epub 2017 Mar 6.

Abstract

Mechanism-based therapy for chronic pain is desperately needed. Recent basic science research demonstrated that remifentanil can reverse long-term potentiation at C-fiber synapses in the dorsal horn of rats. In this exploratory, single group study, patients with chronic post-herpetic pain were treated with a single, one-hour, high-dose remifentanil infusion. The mean overall change of pain intensity seven days after treatment was -18 (-7.5; -28.5, 95%CI, p<0.001) points on the numeric rating scale (0-100) (-33 (±11) points amongst responders only). Eleven of 20 patients responded to treatment (≥30% reduction in pain), the mean relative reduction in pain from baseline amongst responders was 61.0%. These promising preliminary results suggest that a mechanism-based reversal of chronic pain may be impending.

Keywords: Chronic pain; Mechanism-based; Neuropathic; Opioid; Post-herpetic neuralgia; Remifentanil.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuralgia, Postherpetic / drug therapy*
  • Piperidines / administration & dosage
  • Piperidines / therapeutic use
  • Remifentanil

Substances

  • Piperidines
  • Remifentanil