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Tramadol for neuropathic pain

Sudha Arumugam, Christine Sm Lau, Ronald S Chamberlain
OBJECTIVES: Effective postoperative pain management is crucial in the care of surgical patients. Opioids, which are commonly used in managing postoperative pain, have a potential for tolerance and addiction, along with sedating side effects. Gabapentin's use as a multimodal analgesic regimen to treat neuropathic pain has been documented as having favorable side effects. This meta-analysis examined the use of preoperative gabapentin and its impact on postoperative opioid consumption. MATERIALS AND METHODS: A comprehensive literature search was conducted to identify randomized control trials that evaluated preoperative gabapentin on postoperative opioid consumption...
2016: Journal of Pain Research
Janette Nallely Corona-Ramos, Minarda De la O-Arciniega, Myrna Déciga-Campos, José Raúl Medina-López, Adriana Miriam Domínguez-Ramírez, Osmar Antonio Jaramillo-Morales, Josué Vidal Espinosa-Juárez, Francisco Javier López-Muñoz
Preclinical Research The current work evaluates the interaction between two commonly used drugs, tramadol (Tra) and gabapentin (Gbp). Dose-response curves (DRC) and isobolographic analysis were used to confirm their synergistic antihyperalgesic and anti-allodynic responses in a rat neuropathic pain model involving chronic constriction injury of the sciatic nerve and in von Frey and acetone tests. Tra and Gbp produced dose-dependent antihyperalgesic and anti-allodynic effects. Dose-response studies of combinations of Tra and Gbp in combination showed the DRC was leftward-shifted compared to the DRCs for each compound alone...
August 2016: Drug Development Research
Wataru Matsuura, Erika Kageyama, Shinichi Harada, Shogo Tokuyama
Central poststroke pain is associated with specific somatosensory abnormalities, such as neuropathic pain syndrome. Although central poststroke pain is a serious condition, details pertaining to underlying mechanisms are not well established, making current standard treatments only partially effective. Here, we assessed the effects of tramadol, an analgesic drug mediated by opioid receptors, using a mouse model of global cerebral ischemia. Ischemia was induced by bilateral carotid artery occlusion (30 min) in male ddY mice...
June 15, 2016: Neuroreport
E D Isagulyan, A A Tomsky, A V Dekopov, E M Salova, E M Troshina, E V Dorokhov, V A Shabalov
AIM: The article is aimed to demonstrate our experience in motor cortex stimulation (MCS) in patients with chronic neuropathic pain syndromes, assess the clinical efficacy of the technique in short-term and long-term follow-up, and analyze potential predictors of the MCS efficacy. MATERIAL AND METHODS: Twenty patients were implanted with MCS electrodes at the Burdenko Neurosurgical Institute in the period between 2004 and 2014. The mean age of patients was 52 years (26 to 74 years)...
2015: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Yuka Shidahara, Shinya Ogawa, Mari Nakamura, Shingo Nemoto, Yuji Awaga, Miyuki Takashima, Aldric Hama, Akihisa Matsuda, Hiroyuki Takamatsu
Oxaliplatin is a first-line treatment for colorectal cancer. However, shortly following treatment, cold-evoked hypersensitivity appears in the extremities and over time, the pain is such that oxaliplatin dosing may need to be markedly reduced or even terminated. There is currently a lack of efficacious treatments for oxaliplatin-induced peripheral neuropathy, which is due in part to the difficulty in translating findings obtained from preclinical rodent models of chemotherapy-induced peripheral neuropathy. Nonhuman primates (NHP) are phylogenetically closer to humans than rodents and may show drug responses that parallel those of humans...
February 2016: Pharmacology Research & Perspectives
Natália V de Moraes, Gabriela R Lauretti, Eduardo B Coelho, Ana Leonor P C Godoy, Daniel V Neves, Vera L Lanchote
The pharmacokinetics of tramadol is characterized by a large interindividual variability, which is partially attributed to polymorphic CYP2D6 metabolism. The contribution of CYP3A, CYP2B6, fraction unbound, and other potential covariates remains unknown. This study aimed to investigate the contribution of in vivo activities of cytochrome P450 (CYP) 2D6 and 3A as well as other potential covariates (CYP2B6 genotype to the SNP g.15631G>T, fraction unbound, age, body weight, creatinine clearance) to the enantioselective pharmacokinetics of tramadol...
April 2016: Fundamental & Clinical Pharmacology
Antonio Alcántara-Montero, Clara I Sánchez-Carnerero
INTRODUCTION: Most of the clinical practice guidelines consulted agree that tricyclics, dual (venlafaxine/duloxetine) antidepressants, gabapentin/pregabalin antiepileptic drugs, lidocaine 5% patches and capsaicin 8% patches are the first-line drugs in the treatment of peripheral neuropathic pain, being tramadol and some strong opioids (morphine, oxycodone and tapentadol) second-line drugs treatment. Moreover, the prevalence of neuropathic pain refractory to treatment is about 1.5% of the population, so that an estimated 50% of patients not responding to prescribed treatment...
March 1, 2016: Revista de Neurologia
Graham R Hadley, Julie A Gayle, Juan Ripoll, Mark R Jones, Charles E Argoff, Rachel J Kaye, Alan D Kaye
Post-herpetic neuralgia (PHN) is a chronic neuropathic pain condition that persists 3 months or more following an outbreak of shingles. Shingles, also known as acute herpes zoster, is associated with the reactivation of the dormant varicella zoster virus in an individual who has experienced chicken pox. PHN is associated with persistent and often refractory neuropathic pain. Patients may experience multiple types of pain including a constant deep, aching, or burning pain; a paroxysmal, lancinating pain; hyperalgesia (painful stimuli are more painful than expected); and allodynia (pain associated with typically non-painful stimuli)...
March 2016: Current Pain and Headache Reports
Hugo F Miranda, Viviana Noriega, Juan Carlos Prieto, Pilar Zanetta, Rodrigo Castillo, Nicolás Aranda, Fernando Sierralta
Neuropathic pain is the result of injury to the nervous system, and different animal models have been established to meet the manifestations of neuropathy. The pharmacotherapy for neuropathic pain includes gabapentin and tramadol, but these are only partially effective when given alone. The aim of this study was to assess the antinociceptive interaction between both drugs using the isobolographic analysis and changes of the IL-1β concentration in a mouse model of neuropathic pain (partial sciatic nerve ligation or PSNL)...
August 2016: Basic & Clinical Pharmacology & Toxicology
Hari Gopal, Joseph Fitzgerald, Connail McCrory
BACKGROUND: Spinal cord stimulation (SCS) is used for the treatment of chronic neuropathic pain, a notoriously difficult condition to treat. Failed Back Surgery Syndrome (FBSS) and Complex Regional Pain syndrome (CRPS) remain the strongest indications. Funding remains a difficult issue and the use of trial of stimulation is the traditional method of ensuring best outcomes from implantation. METHODS: A retrospective and consecutive review of 80 cases of spinal cord stimulation for patients with a diagnosis of FBSS and CRPS having undergone prior comprehensive medical management and interventional treatment with no sustained benefit...
2016: Journal of Back and Musculoskeletal Rehabilitation
Shota Yamamoto, Takehiro Kawashiri, Hitomi Higuchi, Kuniaki Tsutsumi, Soichiro Ushio, Takanori Kaname, Masafumi Shirahama, Nobuaki Egashira
Bortezomib, an effective anticancer drug for multiple myeloma, often causes peripheral neuropathy which is mainly characterized by numbness and painful paresthesia. Nevertheless, there is no effective strategy to escape or treat bortezomib-induced peripheral neuropathy (BIPN), because we have understood few mechanism of this side effect. In this study, we evaluated behavioral and pathological characteristics of BIPN, and investigated pharmacological efficacy of various analgesic drugs and adjuvants on mechanical allodynia induced by bortezomib treatment in rats...
September 2015: Journal of Pharmacological Sciences
K Raafat, A El-Lakany
BACKGROUND: The prevalence of Diabetes mellitus (DM) is escalating rapidly worldwide, and associated with micro- and macrovascular complications. Diabetic neuropathy (DN) is a common complication of DM, and has a few approved therapies with limited efficacy and several side-effects. Herbal medicine is used worldwide as an effective alternative-medicine. The present study aims to investigate the activities of Ferula hermonis Boiss. EtAc (Ferula) and Sambucus nigra L. aqueous (Elder) extracts, and their potential active isolates; for acute (6 h) and subchronic (8 days) glucose homeostasis, in vivo antioxidant potential and DN amelioration in alloxan-induced DM mice model...
2015: BMC Complementary and Alternative Medicine
Elif Doğan Bakı, Nilgün Kavrut Ozturk, Rauf Umut Ayoğlu, Mustafa Emmiler, Bilge Karslı, Hanife Uzel
Background Sternotomy causes considerable postoperative pain and postoperative pain management encompasses different analgesic regimens. In this study, we aimed to investigate the effect of peroperative parasternal block with levobupivacaine on acute and chronic pain after coronary artery bypass graft surgery. Materials and Methods A total of 81 patients undergoing coronary artery bypass graft surgery were included in this study. Patients were randomly allocated by opening an envelope to receive either parasternal block with pharmacologic analgesia (group P; before sternal wire placement: sternotomy and mediastinal tube sites were infiltrated with local anesthetics) or pharmacologic analgesia alone (group C) for postoperative pain relief...
September 2016: Seminars in Cardiothoracic and Vascular Anesthesia
Claudia Sommer
A recent review and meta-analysis on pharmacotherapy for neuropathic pain provides a precise update on treatment efficacy and adverse effects. The authors offer revised evidence-based recommendations for first-line therapies and subsequent options, but we still a need to improve individual treatment decisions, including nonpharmacological therapies, in affected patients.
May 2015: Nature Reviews. Neurology
Kanako Miyano, Kouichiro Minami, Toru Yokoyama, Katsuya Ohbuchi, Takuhiro Yamaguchi, Satoshi Murakami, Seiji Shiraishi, Masahiro Yamamoto, Motohiro Matoba, Yasuhito Uezono
BACKGROUND: The transient receptor potential vanilloid 1 (TRPV1) and the transient receptor potential ankyrin 1 (TRPA1), which are expressed in sensory neurons, are polymodal nonselective cation channels that sense noxious stimuli. Recent reports showed that these channels play important roles in inflammatory, neuropathic, or cancer pain, suggesting that they may serve as attractive analgesic pharmacological targets. Tramadol is an effective analgesic that is widely used in clinical practice...
April 2015: Anesthesia and Analgesia
Nanna B Finnerup, Nadine Attal, Simon Haroutounian, Ewan McNicol, Ralf Baron, Robert H Dworkin, Ian Gilron, Maija Haanpää, Per Hansson, Troels S Jensen, Peter R Kamerman, Karen Lund, Andrew Moore, Srinivasa N Raja, Andrew S C Rice, Michael Rowbotham, Emily Sena, Philip Siddall, Blair H Smith, Mark Wallace
BACKGROUND: New drug treatments, clinical trials, and standards of quality for assessment of evidence justify an update of evidence-based recommendations for the pharmacological treatment of neuropathic pain. Using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), we revised the Special Interest Group on Neuropathic Pain (NeuPSIG) recommendations for the pharmacotherapy of neuropathic pain based on the results of a systematic review and meta-analysis. METHODS: Between April, 2013, and January, 2014, NeuPSIG of the International Association for the Study of Pain did a systematic review and meta-analysis of randomised, double-blind studies of oral and topical pharmacotherapy for neuropathic pain, including studies published in peer-reviewed journals since January, 1966, and unpublished trials retrieved from ClinicalTrials...
February 2015: Lancet Neurology
Tuukka Saarikoski, Teijo I Saari, Nora M Hagelberg, Janne T Backman, Pertti J Neuvonen, Mika Scheinin, Klaus T Olkkola, Kari Laine
BACKGROUND: Tramadol is widely used for acute, chronic, and neuropathic pain. Its primary active metabolite is O-desmethyltramadol (M1), which is mainly accountable for the μ-opioid receptor-related analgesic effect. Tramadol is metabolized to M1 mainly by cytochrome P450 (CYP)2D6 enzyme and to other metabolites by CYP3A4 and CYP2B6. We investigated the possible interaction of tramadol with the antifungal agents terbinafine (CYP2D6 inhibitor) and itraconazole (CYP3A4 inhibitor). METHODS: We used a randomized placebo-controlled crossover study design with 12 healthy subjects, of which 8 were extensive and 4 were ultrarapid CYP2D6 metabolizers...
March 2015: European Journal of Clinical Pharmacology
W Häuser, K Bernardy, C Maier
BACKGROUND: The efficacy and safety of long-term (≥ 6 months) opioid therapy (LtOT) in chronic noncancer pain (CNCP) is under debate. A systematic review with meta-analysis of the efficacy and harms of opioids in open-label extension studies of randomized controlled trials (RCTs) has not been conducted until now. METHODS: We screened MEDLINE and (through to December 2013), as well as reference sections of systematic reviews of long-term RCTs of opioids in CNCP...
February 2015: Der Schmerz
Dwight Moulin, Aline Boulanger, A J Clark, Hance Clarke, Thuan Dao, G A Finley, Andrea Furlan, Ian Gilron, Allan Gordon, Patricia K Morley-Forster, Barry J Sessle, Pamela Squire, Jennifer Stinson, Paul Taenzer, Ana Velly, Mark A Ware, Erica L Weinberg, Owen D Williamson
BACKGROUND: Neuropathic pain (NeP), redefined as pain caused by a lesion or a disease of the somatosensory system, is a disabling condition that affects approximately two million Canadians. OBJECTIVE: To review the randomized controlled trials (RCTs) and systematic reviews related to the pharmacological management of NeP to develop a revised evidence-based consensus statement on its management. METHODS: RCTs, systematic reviews and existing guidelines on the pharmacological management of NeP were evaluated at a consensus meeting in May 2012 and updated until September 2013...
November 2014: Pain Research & Management: the Journal of the Canadian Pain Society
Vesna Dermanovic Dobrota, Pero Hrabac, Dinko Skegro, Ranko Smiljanic, Savko Dobrota, Ingrid Prkacin, Neva Brkljacic, Kristijan Peros, Martina Tomic, Vesna Lukinovic-Skudar, Vanja Basic Kes
BACKGROUND: Diabetic polyneuropathy (DPN) is one of the most common complications of diabetes and can exist with or without neuropathic pain. We were interested in how neuropathic pain impairs the quality of life in diabetic patients and what is the role of comorbidities in this condition. METHODS: The study included 80 patients with painful DPN (group "P") and 80 patients with DPN, but without neuropathic pain (group "D"). Visual analogue scale (VAS) and Leeds assessment of neuropathic symptoms and signs (LANSS) pain scale were used for assessment of neuropathic pain, SF-36 standardized questionnaire for assessment of the quality of life and BDI questionnaire for assessment of depression...
2014: Health and Quality of Life Outcomes
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