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Volume 16, Number 22,
Issue of November 15, 1996
pp. 7331-7335
Copyright ©1996 Society for Neuroscience
The Sympathetic Nervous System Contributes to Capsaicin-Evoked
Mechanical Allodynia But Not Pinprick Hyperalgesia in Humans
Received June 10, 1996; revised Aug. 19, 1996; accepted Aug. 29, 1996.
Maywin Liu1, 3,
Mitchell
B. Max1,
Suzan Parada2,
Janet S. Rowan2, and
Gary J. Bennett1
1 Neurobiology and Anesthesiology Branch, National
Institute of Dental Research, and 2 Clinical Center
Nursing, National Institutes of Health, Bethesda, Maryland 20892, and 3 Department of Anesthesia, Hospital of the
University of Pennsylvania, Philadelphia, Pennsylvania 19104
The contribution of the sympathetic nervous system (SNS) to
pain, mechanical allodynia (MA), and hyperalgesia in humans is
controversial. A clearer understanding is crucial to guide therapeutic
use of sympatholytic surgery, blocks, and drug treatments. In rats,
capsaicin-evoked MA, and to some extent, pinprick hyperalgesia (PPH),
can be blocked with -adrenoreceptor antagonists. In this study, we
examined the contribution of the SNS to MA and PPH in normal human
subjects by blocking -adrenoreceptors with intravenous
phentolamine.
In a double-blinded, placebo-controlled, crossover study, subjects were
given IV saline or phentolamine, 1 mg/kg over 20 min. Ten minutes after
the start of the infusion, subjects received 100 µg of intradermal
capsaicin on the foot dorsum with the temperature of the injected site
clamped at 36°C. The temperature of the uninjected foot was used to
monitor the degree of -adrenoreceptor blockade produced by
phentolamine. Ongoing pain and MA and PPH areas were measured every 5 min for 60 min.
A significantly greater increase in temperature on the uninjected foot
was seen during the phentolamine infusion compared with the saline
infusion, indicating -adrenergic blockade. Significantly less MA was
observed with the phentolamine infusion 10-25 min after capsaicin
injection than with the saline infusion. No significant differences in
ongoing pain or PPH areas were seen between the two infusions at any
time.
Our results suggest that capsaicin-evoked MA and PPH have different
mechanisms, with the SNS having a role in MA but not in PPH or ongoing
pain.
Key words:
sympathetic nervous system;
mechanical
allodynia;
mechanical hyperalgesia;
capsaicin;
phentolamine;
pain
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