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Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Breivik, Harald

4 Issues per year


CiteScore 2017: 0.84

SCImago Journal Rank (SJR) 2017: 0.401
Source Normalized Impact per Paper (SNIP) 2017: 0.452

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1877-8879
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Volume 17, Issue 1

Quantitative sensory tests fairly reflect immediate effects of oxycodone in chronic low-back pain

Jürg Schliessbach
  • Corresponding author
  • Department of Anesthesiology and Pain Therapy, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Andreas Siegenthaler / Lukas Bütikofer
  • CTU Bern, and Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
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  • De Gruyter OnlineGoogle Scholar
/ Pascal Vuilleumier
  • Department of Anesthesiology and Pain Therapy, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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/ Peter Jüni
  • Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Department of Medicine, University of Toronto, Toronto, Canada
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/ Lars Arendt-Nielsen
  • Centre of Sensory Motor Interaction SMI, School of Medicine, University of Aalborg, Aalborg, Denmark
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/ Michele Curatolo
  • Centre of Sensory Motor Interaction SMI, School of Medicine, University of Aalborg, Aalborg, Denmark
  • Department of Anesthesiology and Pain Medicine, University of Washington, Seattle WA, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2017-10-01 | DOI: https://doi.org/10.1016/j.sjpain.2017.07.004

Abstract

Introduction

Quantitative sensory tests (QST) can be used for profiling anti-nociceptive effects of analgesics. However, anti-nociceptive effects detected by QST are not necessarily associated with analgesic effects in pain patients. As part of a large investigation on low back pain, this paper describes the immediate analgesic and anti-nociceptive effects of oxycodone in chronic low-back pain and ranks different QST according to their ability to reflect this effect. The results are expected to support the selection of QST for future studies on potential novel opioid agonists in human pain.

Methods

In this randomized, placebo-controlled and double-blinded cross-over study, 50 patients with chronic low-back pain received a single oral dose of oxycodone 15 mg or active placebo, and underwent multiple QST testing. The intensity of low-back pain was recorded during 2 h. The areas under the ROC curves and 95% confidence intervals were determined, whereby responder status (≤30% pain reduction) was set as reference variable and changes in QST from baseline were set as classifiers.

Results

Significant analgesic effect on low-back pain as well as anti-nociceptive effects for almost all QST parameters were observed. The QST with the highest area under the curve were heat pain detection threshold (0.65,95%-CI 0.46 to 0.83), single-stimulus electrical pain threshold (0.64,95%-CI 0.47 to 0.80) and pressure pain detection threshold (0.63,95%-CI 0.48 to 0.79).

Conclusions

The results suggest that anti-nociceptive effects assessed by QST fairly reflect clinical efficacy of oxycodone on low-back pain. Pressure pain detection threshold, heat pain detection threshold and single-stimulus electrical pain threshold may be more suitable to sort out potential non-responders rather than identifying potential responders to opioid medication. Future pre-clinical human research may consider these results when investigating the analgesic effect of opioid agonists by means of QST.

Keywords: Quantitative sensory tests; Chronic low-back pain; Oxycodone; Experimental pain; Analgesic effect; Anti-nociceptive effect

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About the article

University Department of Anesthesiology and Pain Therapy, Inselspital, CH-3010 Bern, Switzerland


Received: 2017-05-01

Revised: 2017-06-29

Accepted: 2017-07-05

Published Online: 2017-10-01

Published in Print: 2017-10-01


Ethical issues: This study was approved by the local ethics committee (KEK 213-09) and strictly followed the GCP guidelines and Helsinki declaration. All participants gave written informed consent prior to enrolment. The study was registered with clinicaltrials.gov (NCT01179828).

Conflicts of interest: The authors declare that they have no conflict of interests.


Citation Information: Scandinavian Journal of Pain, Volume 17, Issue 1, Pages 107–115, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1016/j.sjpain.2017.07.004.

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