The clinical and laboratorial evaluation of transdermal ketamine, fentanyl, clonidine or their combination in chronic low back pain Evaluación clínica y de laboratorio de cetamina transdérmica, del fentanyl transdérmico, de la clonidina transdérmica o de sus asociaciones en el dolor lumbar crónico Avaliação clínica e laboratorial da cetamina transdérmica, do fentanil transdérmico, da clonidina transdérmica ou suas associações na dor lombar crônica

OBJECTIVES: chronic low back pain may result in central sensitization, with involvement of different receptors. The aim of this study was to evaluate the analgesic action of transdermal (T) ketamine (a NMDA antagonist), clonidine (an α2-agonist), fentanyl (an opioid agonist), or their combination in...

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Bibliographic Details
Published in:Coluna 2009-12, Vol.8 (4), p.434-440
Main Authors: Gabriela Rocha Lauretti, Márcio Matsumoto, Anita Leocádia de Mattos, Vera Lanchote, Newton Lindolfo Pereira
Format: Article
Language:English
Subjects:
Administración cutánea
Administration, cutaneous
Administração cutânea
Analgesia epidural
Analgesics
Analgésicos
Cetamina
Clonidina
Clonidine
Dolor de la región lumbar
Dor lombar
Fentanila
Fentanilo
Fentanyl
Ketamina
Ketamine
Low back pain
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Summary:OBJECTIVES: chronic low back pain may result in central sensitization, with involvement of different receptors. The aim of this study was to evaluate the analgesic action of transdermal (T) ketamine (a NMDA antagonist), clonidine (an α2-agonist), fentanyl (an opioid agonist), or their combination in chronic low back pain. METHODS: after the institutional approval and informed consent signature, 54 patients were prospectively randomized into 6 groups. Each patient had two of the T preparations applied in different arms. The effect of either T ketamine (1 mg/h), T clonidine (25 µg/h) or T fentanyl (25 µg/h), combined with T placebo (CloG, KetG and FenG); or the combination of T ketamine and clonidine (Ket-CloG), T fentanyl and ketamine (Fen-KetG), or T fentanyl and clonidine (Fen-CloG) was searched for pain and adverse effects. Pain was evaluated by: 1) VAS pain scores, and 2) noradrenaline plasma levels at 0-h (just prior to T application), 3- and 6-h after the T application of two medications, by HPLC. RESULTS: clinically, the pain VAS score at 6-h was smaller in comparison to the 0-h in all groups (p
ISSN:1808-1851
2177-014X
DOI:10.1590/S1808-18512009000400016