NMDA receptor antagonists and pain relief: A meta-analysis of experimental trials.

Acute Pain / drug therapy Dextromethorphan / therapeutic use Excitatory Amino Acid Antagonists / therapeutic use Humans Hyperalgesia / drug therapy Ketamine / therapeutic use Models, Theoretical Receptors, N-Methyl-D-Aspartate / antagonists & inhibitors

Journal

Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060

Informations de publication

Date de publication:
02 04 2019
Historique:
received: 16 08 2018
accepted: 06 12 2018
pubmed: 8 3 2019
medline: 18 12 2019
entrez: 8 3 2019
Statut: ppublish

Résumé

We conducted a meta-analysis of controlled trials that used experimental models of acute pain and hyperalgesia to examine the analgesic effects of NMDA receptor (NMDAR) antagonists. Six major databases were systematically searched (to March 2018) for studies using human evoked pain models to compare NMDAR antagonists with no-intervention controls. Pain outcome data were analyzed with random-effects meta-analysis. Searches identified 70 eligible trials (n = 1,069). Meta-analysis found that low-dose ketamine (<1 mg/kg) produced a decrease in hyperalgesic area (standardized mean difference 0.54, 95% confidence interval [CI] 0.34, 0.74, Findings provide robust evidence for analgesic and antihyperalgesic effects of ketamine, supporting its utility for acute and chronic pain management. However, pain relief was modest, suggesting ketamine may potentially be most useful when opioids are contraindicated, rapid analgesia is required, or for pain resistant to conventional medication.

Identifiants

DOI: 10.1212/WNL.0000000000007238 PMID: 30842296
pubmed: 30842296
pii: WNL.0000000000007238
doi: 10.1212/WNL.0000000000007238
doi:

Substances chimiques

Excitatory Amino Acid Antagonists 0
Receptors, N-Methyl-D-Aspartate 0
Ketamine 690G0D6V8H
Dextromethorphan 7355X3ROTS

Types de publication

Journal Article Meta-Analysis Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e1652-e1662

Subventions

Organisme : Department of Health
ID : ICA-CL-2017-03-001
Pays : United Kingdom

Informations de copyright

© 2019 American Academy of Neurology.

Auteurs

Trevor Thompson (T)

From the Faculty of Education and Health (T.T., F.W.), University of Greenwich, London; York Health Economics Consortium (F.W.), University of York; Acaster Lloyd Consulting Ltd. (K.G.), London, UK; Neurosciences Department (N.V.), Aging Branch, National Research Council, Padova; Neuroscience Centre (M.S.), University of Padova, Italy; Department of Adult Nursing & Paramedic Science (P.N.), University of Greenwich, London; Physiotherapy Department (B.S.), South London and Maudsley NHS Foundation Trust; and Department of Psychological Medicine (B.S.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK. t.thompson@gre.ac.uk.
ORCID: 0000-0001-9880-782X

Fiona Whiter (F)

From the Faculty of Education and Health (T.T., F.W.), University of Greenwich, London; York Health Economics Consortium (F.W.), University of York; Acaster Lloyd Consulting Ltd. (K.G.), London, UK; Neurosciences Department (N.V.), Aging Branch, National Research Council, Padova; Neuroscience Centre (M.S.), University of Padova, Italy; Department of Adult Nursing & Paramedic Science (P.N.), University of Greenwich, London; Physiotherapy Department (B.S.), South London and Maudsley NHS Foundation Trust; and Department of Psychological Medicine (B.S.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK.

Katy Gallop (K)

From the Faculty of Education and Health (T.T., F.W.), University of Greenwich, London; York Health Economics Consortium (F.W.), University of York; Acaster Lloyd Consulting Ltd. (K.G.), London, UK; Neurosciences Department (N.V.), Aging Branch, National Research Council, Padova; Neuroscience Centre (M.S.), University of Padova, Italy; Department of Adult Nursing & Paramedic Science (P.N.), University of Greenwich, London; Physiotherapy Department (B.S.), South London and Maudsley NHS Foundation Trust; and Department of Psychological Medicine (B.S.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK.
ORCID: 0000-0002-6826-3865

Nicola Veronese (N)

From the Faculty of Education and Health (T.T., F.W.), University of Greenwich, London; York Health Economics Consortium (F.W.), University of York; Acaster Lloyd Consulting Ltd. (K.G.), London, UK; Neurosciences Department (N.V.), Aging Branch, National Research Council, Padova; Neuroscience Centre (M.S.), University of Padova, Italy; Department of Adult Nursing & Paramedic Science (P.N.), University of Greenwich, London; Physiotherapy Department (B.S.), South London and Maudsley NHS Foundation Trust; and Department of Psychological Medicine (B.S.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK.
ORCID: 0000-0002-9328-289X

Marco Solmi (M)

From the Faculty of Education and Health (T.T., F.W.), University of Greenwich, London; York Health Economics Consortium (F.W.), University of York; Acaster Lloyd Consulting Ltd. (K.G.), London, UK; Neurosciences Department (N.V.), Aging Branch, National Research Council, Padova; Neuroscience Centre (M.S.), University of Padova, Italy; Department of Adult Nursing & Paramedic Science (P.N.), University of Greenwich, London; Physiotherapy Department (B.S.), South London and Maudsley NHS Foundation Trust; and Department of Psychological Medicine (B.S.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK.
ORCID: 0000-0003-4877-7233

Paul Newton (P)

From the Faculty of Education and Health (T.T., F.W.), University of Greenwich, London; York Health Economics Consortium (F.W.), University of York; Acaster Lloyd Consulting Ltd. (K.G.), London, UK; Neurosciences Department (N.V.), Aging Branch, National Research Council, Padova; Neuroscience Centre (M.S.), University of Padova, Italy; Department of Adult Nursing & Paramedic Science (P.N.), University of Greenwich, London; Physiotherapy Department (B.S.), South London and Maudsley NHS Foundation Trust; and Department of Psychological Medicine (B.S.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK.
ORCID: 0000-0002-8525-6763

Brendon Stubbs (B)

From the Faculty of Education and Health (T.T., F.W.), University of Greenwich, London; York Health Economics Consortium (F.W.), University of York; Acaster Lloyd Consulting Ltd. (K.G.), London, UK; Neurosciences Department (N.V.), Aging Branch, National Research Council, Padova; Neuroscience Centre (M.S.), University of Padova, Italy; Department of Adult Nursing & Paramedic Science (P.N.), University of Greenwich, London; Physiotherapy Department (B.S.), South London and Maudsley NHS Foundation Trust; and Department of Psychological Medicine (B.S.), Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK.
ORCID: 0000-0001-7387-3791

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Classifications MeSH

questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Douleur aigüe › NMDA receptor antagonists and pain relief: A...
questionsmedicales.fr › Composés polycycliques › Hydrocarbures aromatiques polycycliques › Phénanthrènes › Morphinanes › Dextrométhorphane › NMDA receptor antagonists and pain relief: A...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Effets physiologiques des médicaments › Agents neuromédiateurs › Agents des acides aminés excitateurs › Antagonistes des acides aminés excitateurs › NMDA receptor antagonists and pain relief: A...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › NMDA receptor antagonists and pain relief: A...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Troubles sensitifs › Troubles somatosensoriels › Hyperalgésie › NMDA receptor antagonists and pain relief: A...
questionsmedicales.fr › Composés chimiques organiques › Hydrocarbures › Hydrocarbures cycliques › Hydrocarbures alicycliques › Cyclohexanes › Kétamine › NMDA receptor antagonists and pain relief: A...
questionsmedicales.fr › Techniques d'investigation › Modèles théoriques › NMDA receptor antagonists and pain relief: A...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Protéines membranaires › Récepteurs de surface cellulaire › Récepteurs aux neuromédiateurs › Récepteurs aux acides aminés › Récepteurs au glutamate › Récepteurs ionotropes du glutamate › Récepteurs du N-méthyl-D-aspartate › NMDA receptor antagonists and pain relief: A...