NMDA receptor blockade in chronic neuropathic pain: a comparison of ketamine and magnesium chloride

Pain. 1996 Feb;64(2):283-291. doi: 10.1016/0304-3959(95)00113-1.

Abstract

Ten patients (4 female, 6 male) aged 34-67 years suffering from peripheral neuropathic pain participated in a double-blind placebo-controlled study where ketamine or magnesium chloride were administered by a 10 min bolus infusion (ketamine: 0.84 mumol/kg = 0.2 mg/kg, magnesium: 0.16 mmol/kg) followed by a continuous infusion (ketamine: 1.3 mumol/kg/h = 0.3 mg/kg/h, magnesium: 0.16 mmol/kg/h). Ongoing pain determined by VAS score, area of touch-evoked allodynia, detection and pain thresholds to mechanical and thermal stimuli were measured before and during drug infusion. Ketamine produced a significant reduction of spontaneous pain (57%) and of the area of allodynia (33%). Magnesium chloride reduced pain (29%) and area of allodynia (18%) insignificantly. Following ketamine there was a significant correlation between the reduction in ongoing pain and reduction in area of touch-evoked allodynia. Detection and pain thresholds to mechanical and thermal stimuli were not significantly changed by the drugs. These findings suggest that both ongoing pain and touch-evoked pain (allodynia) in neuropathic pain are inter-related phenomena, which may be mediated by the same mechanism and involving a N-methyl-D-aspartate receptor.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anesthetics, Dissociative / administration & dosage
  • Anesthetics, Dissociative / adverse effects
  • Anesthetics, Dissociative / therapeutic use*
  • Chronic Disease
  • Double-Blind Method
  • Female
  • Humans
  • Hyperalgesia / drug therapy
  • Ketamine / administration & dosage
  • Ketamine / adverse effects
  • Ketamine / therapeutic use*
  • Magnesium Chloride / administration & dosage
  • Magnesium Chloride / adverse effects
  • Magnesium Chloride / therapeutic use*
  • Male
  • Middle Aged
  • Pain / drug therapy*
  • Pain / etiology
  • Pain / psychology
  • Pain Measurement
  • Pain Threshold / drug effects
  • Peripheral Nervous System Diseases / complications*
  • Physical Stimulation
  • Receptors, N-Methyl-D-Aspartate / antagonists & inhibitors*

Substances

  • Anesthetics, Dissociative
  • Receptors, N-Methyl-D-Aspartate
  • Magnesium Chloride
  • Ketamine