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Treatment of chronic pain is a major clinical challenge since chronic pain is frequent and leads to deterioration of quality of life. An injury or wound can lead to long term changes in the nervous system that make the skin more sensitive at and near the injury; this is termed hyperalgesia and occurs through long term depotentiation (LTP), i.e., a change in the synaptic interaction between neurons.
Opioids are the gold standard for the symptomatic therapy of moderate to severe pain. Now, in animal studies the investigators have discovered previously unrecognized effects of opioids.
UV-B irradaition of the skin of the thigh is an established model of priamary and secondary hyperalgeisa in humans. The investigators want to test the influence of remifentanil, an ultra-short acting opioid, on hyperalgesia observed after UV-B irradiation in human volunteers in a double blind cross-over prospective active placebo controlled clinical trial, at a dose corresponding to 0.7 µg kg-1 min-1.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Remifentanil | Experimental | Remifentanil Infusion |
|
| Midazolam | Active Comparator | Active Placebo |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Remifentanil | Drug | Remifentanil Infusion |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| Measure: Area of pin prick hyperalgesia | 0-6h |
| Measure | Description | Time Frame |
|---|---|---|
| Stimulus-response (SR) function to a set of modified rigid von Frey filaments (8-512 mN) | 0-6h | |
| Heat pain threshold within the area of mechanical hyperalgesia | 0-6h | |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Astrid Chiari, MD | Medical University of Vienna | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Anaesthesia, Medical University of Vienna | Recruiting | Vienna | State of Vienna | 1090 | Austria |
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| ID | Term |
|---|---|
| D006930 | Hyperalgesia |
| D013471 | Sunburn |
| ID | Term |
|---|---|
| D020886 | Somatosensory Disorders |
| D012678 | Sensation Disorders |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D000077208 | Remifentanil |
| D008874 | Midazolam |
| ID | Term |
|---|---|
| D011422 | Propionates |
| D000144 | Acids, Acyclic |
| D002264 | Carboxylic Acids |
| D009930 | Organic Chemicals |
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| Midazolam | Drug | Midazolam Infusion |
|
|
| Mechanical pain threshold within the area of pin prick hyperalgesia, area of dynamic allodynia to brush |
| 0-6h |
| Adverse effects | 30 and 59 min after start of treatment |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010787 | Photosensitivity Disorders |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D002056 | Burns |
| D014947 | Wounds and Injuries |
| D010880 |
| Piperidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D001569 | Benzodiazepines |
| D001552 | Benzazepines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |