High-Dose Opioids May Delete Memory Trace of Pain

From Anesthesiology News
Austrian researchers have discovered a surprising, new potential effect of opioids: The drugs not only temporarily dampen pain but in high doses may remove the spinal cord’s memory trace of pain (Science 2012;335:235-238). The memory trace, which can amplify a person’s experience of pain and may lead to chronic pain syndromes, can be triggered by several mechanisms, including long-term synaptic potentiation.

In order to study pain memory, the researchers recreated a surgical procedure in vivo, which allowed them to stimulate pain fibers under controlled conditions. Despite deep anesthesia, the researchers were able to reserve long-term synaptic potentiation in the spinal cord and found a memory trace for pain. When high doses of IV opioids were administered over the course of an hour, the researchers completely resolved the potentiation and thus deleted the memory trace for pain.

Based on these results, a new project, sponsored by the Vienna Fund for Science, Research and Technology, is exploring whether this discovery can be used to treat patients.

“If our approach turns out to be effective under clinical conditions, this would herald a paradigm shift in pain therapy,” wrote the authors, led by Jürgen Sandkühler, MD, at the Center for Brain Research at the Medical University of Vienna. “It would mean moving away from the temporary, purely symptom-based pain therapy to a long-term removal of the cause of pain based on pain mechanisms using opioids.”

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