Healthy Clinical Trial
Official title:
Effect of Intrathecal Ketorolac on Mechanical Hypersensitivity Following Acute Opioid Exposure
This research study is being done because pain is a significant problem for patients with a
variety of medical problems and following surgery or traumatic injury. Currently available
pain medications may not treat all types of pain or may treat pain only at doses that produce
side effects and complications. The medication in this study may have a role in better
treatment of pain. The goals of this study are to see if a dose of ketorolac (non-narcotic,
pain reliever), given into the fluid in the back near the spine has any effect on pain or
discomfort in the skin sensation that will take place after applying capsaicin (chili pepper)
cream. The sunburn-like sensation that people experience after having capsaicin cream applied
is similar to, but much milder than, the pain that some people have after surgery and after
certain types of nerve injuries. This study will test the effects of combining two
medications that are often given together to control postoperative pain or pain from a nerve
injury. The investigators are especially interested in answering two questions about the
effects of ketorolac (non-narcotic pain reliever) and remifentanil (intravenous [IV] narcotic
painkiller):
1. How much does remifentanil (narcotic painkiller) affect the sunburn-like painful area on
your skin, which develops after applying capsaicin cream?
2. What pain relieving effects does spinal ketorolac have when given with IV remifentanil?
Intravenous (IV) remifentanil stimulates spinal COX activity, leading to increased
Cerebrospinal fluid CSF) prostaglandin E2 (PGE2) concentrations and areas of
capsaicin-induced mechanical hypersensitivity after remifentanil infusion, and these effects
will be blocked by intrathecal ketorolac.
Areas of mechanical hyperalgesia and allodynia will be established by topical capsaicin +
intermittent heat in healthy volunteers, who will be randomized to receive intrathecal saline
or ketorolac during remifentanil infusion, with primary outcome measure area of hyperalgesia
and secondary outcome measure Cerebrospinal fluid (CSF) prostaglandin E2 (PGE2) concentration
after stopping remifentanil.
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