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KMID : 1001920100470060420
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Journal of Korean Neurosurgical Society
2010 Volume.47 No. 6 p.420 ~ p.423
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Involvement of Selective Alpha-2 Adrenoreceptor in Sympathetically Maintained Pain
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Park Chan-Hong
Yong An
Lee Sang-Ho
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Abstract
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Objective: Peripheral nerve injury often leads to neuropathic pain, which is characterized by burning pain, allodynia, and hyperalgesia. The role of the sympathetic nervous system in neuropathic pain is a complex and controversial issue. It is generally accepted that the alpha adrenoreceptor (AR) in sympathetic nerve system plays a significant role in the maintenance of pain. Among alpha adrenoreceptor, alpha-1 receptors play a major role in the sympathetic mediated pain. The primary goal of this study is to test the hypothesis that sympathetically maintained pain involves peripheral alpha-2 receptors in human.
Methods: The study was a randomized, prospective, double-blinded, crossover study involving twenty patients. The treatments were : Yohimbine (30 mg mixed in 500 mL normal saline), and Phentolamine (1 mg/kg in 500 mL normal saline) in 500 mL normal saline at 70 mL/hr initially then titrated. The patients underwent infusions on three different appointments, at least one month apart. Thus, all patients received all 2 treatments. Pain measurement was by visual analogue scale, neuropathic pain questionnaire, and McGill pain questionnaire.
Results: There were significant decreases in the visual analogue scale, neuropathic score, McGill pain score of yohimnine, and phentolamine.
Conclusion: We conclude that alpha-2 adrenoreceptor, along with alpha-2 adrenoreceptor, may be play role in sympathetically maintained pain in human.
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KEYWORD
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Reflex sympathetic dystrophy, Yohimbine, Alpha-2 antagonist
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