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Analgesic Effects of Intranasal Ketamine in Rat Models of Facial Pain

  • Rafaela Claudino1
  • Carina Nones1
  • Erika Araya1
  • Juliana Chichorro1,*,

1Univ Fed Parana, Dept Pharmacol, Pharmacol Postgrad Program, Curitiba, Parana, Brazil

DOI: 10.11607/ofph.1973 Vol.32,Issue 3,September 2018 pp.238-246

Published: 30 September 2018

*Corresponding Author(s): Juliana Chichorro E-mail: juliana.chichorro@ufpr.br

Abstract

Aims: To assess the analgesic effect of intranasal administration of S-ketamine in different rat models of facial pain. Methods: Nociceptive responses induced by formalin injected into the upper lip and facial hyperalgesia induced by capsaicin or carrageenan injected into the upper lip were used to evaluate the analgesic effect of intranasal ketamine in acute facial pain models in rats (n = 173). The effect of intranasal ketamine on heat and mechanical hyperalgesia induced by constriction of the infraorbital nerve (CION) was also evaluated. In addition, locomotor activity in the open field test was assessed after intranasal ketamine administration. Two-way repeated measures analysis of variance followed by Bonferroni post hoc correction were used to analyze all data. Results: Intranasal ketamine (0.5 mg/kg) failed to modify the first phase of the orofacial formalin test, but reduced the second phase by about 40%. Intranasal ketamine also reduced the facial heat hyperalgesia induced by capsaicin and carrageenan. In the CION model, intranasal ketamine at 0.5 mg/kg reversed the heat hyperalgesia and at 1 mg/kg attenuated the mechanical hyperalgesia 4 and 14 days after the surgery, respectively. The open field test did not reveal locomotor deficits in rats treated with intranasal ketamine. Conclusion: This study has demonstrated that intranasal ketamine produces analgesic effects in inflammatory and neuropathic facial pain models and may represent an adjuvant in the treatment of such conditions, especially when rapid pain relief is needed.

Keywords

formalin test;heat hyperalgesia;inflammatory pain;ketamine;mechanical hyperalgesia;NMDA receptors;trigeminal neuropathic pain

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Rafaela Claudino,Carina Nones,Erika Araya,Juliana Chichorro. Analgesic Effects of Intranasal Ketamine in Rat Models of Facial Pain. Journal of Oral & Facial Pain and Headache. 2018. 32(3);238-246.

References

1.Domino EF. Taming the ketamine tiger. 1965. Anesthesiology 2010;113:678–684.

2.Bell RF. Ketamine for chronic non-cancer pain. Pain 2009; 141:210–214.

3.Sin B, Tatunchak T, Paryavi M, et al. The use of ketamine for acute treatment of pain: A randomized, double-blind, placebo-controlled trial. J Emerg Med 2017;52:601–608.

4.Allen CA, Ivester JR Jr. Ketamine for pain management—Side effects & potential adverse events. Pain Manag Nurs 2017;18:372–377.

5.Marchetti F, Coutaux A, Bellanger A, Magneux C, Bourgeois P, Mion G. Efficacy and safety of oral ketamine for the relief of intractable chronic pain: A retrospective 5-year study of 51 patients. Eur J Pain 2015;19:984–993.

6.Sigtermans MJ, van Hilten JJ, Bauer MC, et al. Ketamine produc-es effective and long-term pain relief in patients with Complex Regional Pain Syndrome Type 1. Pain 2009;145:304–311.

7.Bell RF. Ketamine for chronic noncancer pain: Concerns regard-ing toxicity. Curr Opin Support Palliat Care 2012;6:183–187.

8.Peltoniemi MA, Hagelberg NM, Olkkola KT, Saari TI. Ketamine: A review of clinical pharmacokinetics and pharmacodynam-ics in anesthesia and pain therapy. Clin Pharmacokinet 2016; 55:1059–1077.

9.Carr DB, Goudas LC, Denman WT, et al. Safety and efficacy of intranasal ketamine for the treatment of breakthrough pain in patients with chronic pain: A randomized, double-blind, placebo-controlled, crossover study. Pain 2004;108:17–27.

10.Huge V, Lauchart M, Magerl W et al. Effects of low-dose intra-nasal (S)-ketamine in patients with neuropathic pain. Eur J Pain 2010;14:387–394.

11.Kulbe J. The use of ketamine nasal spray for short-term analge-sia. Home Healthc Nurse 1998;16:367–370.

12.Malinovsky JM, Servin F, Cozian A, Lepage JY, Pinaud M. Ketamine and norketamine plasma concentrations after i.v., na-sal and rectal administration in children. Br J Anaesth 1996;77: 203–207.

13.Yanagihara Y, Ohtani M, Kariya S, et al. Plasma concentration profiles of ketamine and norketamine after administration of various ketamine preparations to healthy Japanese volunteers. Biopharm Drug Dispos 2003;24:37–43.

14.Johnson NJ, Hanson LR, Frey WH. Trigeminal pathways deliver a low molecular weight drug from the nose to the brain and orofacial structures. Mol Pharm 2010;7:884–893.

15.Arendt-Nielsen L, Nielsen J, Petersen-Felix S, Schnider TW, Zbinden AM. Effect of racemic mixture and the (S+)-isomer of ketamine on temporal and spatial summation of pain. Br J Anaesth 1996;77:625–631.

16.Mathisen LC, Skjelbred P, Skoglund LA, Oye I. Effect of ket-amine, an NMDA receptor inhibitor, in acute and chronic orofa-cial pain. Pain 1995;61:215–220.

17.Mion G, Villevieille T. Ketamine pharmacology: An update (pharmacodynamics and molecular aspects, recent findings). CNS Neurosci Ther 2013;19:370–380.

18.Gupta R, Sharma K, Dhiman UK. Effect of a combination of oral midazolam and low-dose ketamine on anxiety, pain, swell-ing, and comfort during and after surgical extractions of man-dibular third molars. Indian J Dent Res 2012;23:295–296.

19.Hadhimane A, Shankariah M, Neswi KV. Pre-emptive analge-sia with ketamine for relief of postoperative pain after surgical removal of impacted mandibular third molars. J Maxillofac Oral Surg 2016;15:156–163.

20.Kaviani N, Khademi A, Ebtehaj I, Mohammadi Z. The effect of orally administered ketamine on requirement for anesthetics and postoperative pain in mandibular molar teeth with irrevers-ible pulpitis. J Oral Sci 2011;53:461–465.

21.Satilmis¸ T, Garip H, Arpaci E, Sener C, Göker K. Assessment of combined local anesthesia and ketamine for pain, swelling, and trismus after surgical extraction of third molars. J Oral Maxillofac Surg 2009;67:1206–1210.

22.Shah A, Halli R, Merchant Y, Kshirsagar R, Khurana J. Efficacy of ketamine as an adjunct to local anesthesia in the surgical removal of impacted mandibular third molars—A split mouth prospective controlled clinical study. J Clin Diagn Res 2016; 10:ZC29–ZC33.

23.Rabben T, Øye I. Interindividual differences in the analgesic response to ketamine in chronic orofacial pain. Eur J Pain 2001;5:233–240.

24.Motta EM, Chichorro JG, Rae GA. Role of ET(A) and ET(B) endothelin receptors on endothelin-1-induced potentiation of nociceptive and thermal hyperalgesic responses evoked by capsaicin in rats. Neurosci Lett 2009;457:146–150.

25.Andolfatto G, Willman E, Joo D, et al. Intranasal ketamine for analgesia in the emergency department: A prospective obser-vational series. Acad Emerg Med 2013;20:1050–1054.

26.Yeaman F, Meek R, Egerton-Warburton D, Rosengarten P, Graudins A. Sub-dissociative-dose intranasal ketamine for moderate to severe pain in adult emergency department pa-tients. Emerg Med Australas 2014;26:237–242.

27.Chichorro JG, Lorenzetti BB, Zampronio AR. Involvement of bradykinin, cytokines, sympathetic amines and prostaglan-dins in formalin-induced orofacial nociception in rats. Br J Pharmacol 2004;141:1175–1184.

28.Vos BP, Strassman AM, Maciewicz RJ. Behavioral evidence of trigeminal neuropathic pain following chronic constriction injury to the rat’s infraorbital nerve. J Neurosci 1994;14:2708–2723.

29Chichorro JG, Zampronio AR, Souza GE, Rae GA. Orofacial cold hyperalgesia due to infraorbital nerve constriction injury in rats: Reversal by endothelin receptor antagonists but not non-steroidal anti-inflammatory drugs. Pain 2006;123:64–74.

30.Almeida RT, Duarte ID. Nitric oxide/cGMP pathway mediates orofacial antinociception induced by electroacupuncture at the St36 acupoint. Brain Res 2008;1188:54–60.

31.Luiz AP, Schroeder SD, Chichorro JG, Calixto JB, Zampronio AR, Rae GA. Kinin B(1) and B(2) receptors contribute to oro-facial heat hyperalgesia induced by infraorbital nerve constric-tion injury in mice and rats. Neuropeptides 2010;44:87–92.

32.Kopruszinski CM, Reis RC, Chichorro JG. B vitamins relieve neuropathic pain behaviors induced by infraorbital nerve con-striction in rats. Life Sci 2012;91:1187–1195.

33.Kopruszinski CM, Reis RC, Bressan E, Reeh PW, Chichorro JG. Vitamin B complex attenuated heat hyperalgesia following infraorbital nerve constriction in rats and reduced capsaicin in vivo and in vitro effects. Eur J Pharmacol 2015;762:326–332.

34.Hummig W, Kopruszinski CM, Chichorro JG. Pregabalin re-duces acute inflammatory and persistent pain associated with nerve injury and cancer in rat models of orofacial pain. J Oral Facial Pain Headache 2014;28:350–359.

35.Chichorro JG, Zampronio AR, Cabrini DA, Franco CR, Rae GA. Mechanisms operated by endothelin ETA and ETB recep-tors in the trigeminal ganglion contribute to orofacial thermal hyperalgesia induced by infraorbital nerve constriction in rats. Neuropeptides 2009;43:133–142.

36.Christensen D, Gautron M, Guilbaud G, Kayser V. Combined systemic administration of the glycine/NMDA receptor antag-onist, (+)-HA966 and morphine attenuates pain-related be-haviour in a rat model of trigeminal neuropathic pain. Pain 1999; 83:433–440.

37.Chichorro JG, Zampronio AR, Rae GA. Endothelin ET(B) re-ceptor antagonist reduces mechanical allodynia in rats with trigeminal neuropathic pain. Exp Biol Med (Maywood) 2006; 231:1136–1140.

38.Chioca LR, Raupp IM, Da Cunha C, Losso EM, Andreatini R. Subchronic fluoride intake induces impairment in habituation and active avoidance tasks in rats. Eur J Pharmacol 2008; 579:196–201.

39.Farnia MR, Jalali A, Vahidi E, Momeni M, Seyedhosseini J, Saeedi M. Comparison of intranasal ketamine versus IV mor-phine in reducing pain in patients with renal colic. Am J Emerg Med 2017;35:434–437.

40.Shimonovich S, Gigi R, Shapira A, et al. Intranasal ketamine for acute traumatic pain in the emergency department: A pro-spective, randomized clinical trial of efficacy and safety. BMC Emerg Med 2016;16:43.

41.Shrestha R, Pant S, Shrestha A, Batajoo KH, Thapa R, Vaidya S. Intranasal ketamine for the treatment of patients with acute pain in the emergency department. World J Emerg Med 2016;7:19–24.

42.Radvansky BM, Shah K, Parikh A, Sifonios AN, Le V, Eloy JD. Role of ketamine in acute postoperative pain management: A narrative review. Biomed Res Int 2015;2015:749837.

43.Christensen K, Rogers E, Green GA, et al. Safety and efficacy of intranasal ketamine for acute postoperative pain. Acute Pain 2007;9:183–192.

44.Johansson J, Sjöberg J, Nordgren M, Sandström E, Sjöberg F, Zetterström H. Prehospital analgesia using nasal adminis-tration of S-ketamine—A case series. Scand J Trauma Resusc Emerg Med 2013;21:38.

45.Persson J. Ketamine in pain management. CNS Neurosci Ther 2013;19:396–402.

46.Eide PK, Stubhaug A. Relief of glossopharyngeal neuralgia by ketamine-induced N-methyl-aspartate receptor blockade. Neurosurgery 1997;41:505–508.

47.Orser BA, Pennefather PS, MacDonald JF. Multiple mecha-nisms of ketamine blockade of N-methyl-D-aspartate recep-tors. Anesthesiology 1997;86:903–917.

48.Chaplan SR, Malmberg AB, Yaksh TL. Efficacy of spinal NMDA receptor antagonism in formalin hyperalgesia and nerve injury evoked allodynia in the rat. J Pharmacol Exp Ther 1997; 280:829–838.

49.Yamamoto T, Yaksh TL. Comparison of the antinociceptive ef-fects of pre- and posttreatment with intrathecal morphine and MK801, an NMDA antagonist, on the formalin test in the rat. Anesthesiology 1992;77:757–763.

50.Yang Y, Guo QL, Zou WY, Wang E, Yan JQ. Effect of intra-thecal ketamine injection on protein kinase C expression in the spinal dorsal horn of rats with formalin-induced pain [in Chinese]. Nan Fang Yi Ke Da Xue Xue Bao 2011;31:461–464.

51.Luccarini P, Sessle BJ, Woda A. Superficial and deep con-vergent nociceptive neurons are differentially affected by N- methyl-D-aspartate applied on the brainstem surface of the rat medullary dorsal horn. Neuroscience 2001;107:311–316.

52.Parada CA, Luccarini P, Woda A. Effect of an NMDA receptor antagonist on the wind-up of neurons in the trigeminal oralis subnucleus. Brain Res 1997;761:313–320.

53.Otahara N, Ikeda T, Sakoda S, Shiba R, Nishimori T. Involvement of NMDA receptors in Zif/268 expression in the trigeminal nucleus caudalis following formalin injection into the rat whisker pad. Brain Res Bull 2003;62:63–70.

54.Yu XM, Sessle BJ, Haas DA, Izzo A, Vernon H, Hu JW. Involvement of NMDA receptor mechanisms in jaw electromyo-graphic activity and plasma extravasation induced by inflam-matory irritant application to temporomandibular joint region of rats. Pain 1996;68:169–178.

55.Dong XD, Mann MK, Sessle BJ, Arendt-Nielsen L, Svensson P, Cairns BE. Sensitivity of rat temporalis muscle afferent fi-bers to peripheral N-methyl-D-aspartate receptor activation. Neuroscience 2006;141:939–945.

56.Ro JY, Capra NF, Lee JS, Masri R, Chun YH. Hypertonic saline-induced muscle nociception and c-fos activation are partially mediated by peripheral NMDA receptors. Eur J Pain 2007;11:398–405.

57.Wong H, Kang I, Dong XD, et al. NGF-induced mechanical sensitization of the masseter muscle is mediated through pe-ripheral NMDA receptors. Neuroscience 2014;269:232–244.

58.Weng HR, Dougherty PM. Response properties of dorsal root reflexes in cutaneous C fibers before and after intradermal capsaicin injection in rats. Neuroscience 2005;132:823–831.

59.Wu J, Fang L, Lin Q, Willis WD. Nitric oxide synthase in spi-nal cord central sensitization following intradermal injection of capsaicin. Pain 2001;94:47–58.

60.Fletcher D, Le Corre P, Guilbaud G, LeVerge R. Antinociceptive effect of bupivacaine encapsulated in poly(D,L)-lactide-co-glycolide microspheres in the acute inflammatory pain mod-el of carrageenin-injected rats. Anesth Analg 1997;84:90–94.

61.Kayser V, Guilbaud G. Local and remote modifications of noci-ceptive sensitivity during carrageenin-induced inflammation in the rat. Pain 1987;28:99–107.

62.Rivat C, Laulin JP, Corcuff JB, Célèrier E, Pain L, Simonnet G. Fentanyl enhancement of carrageenan-induced long-lasting hy-peralgesia in rats: Prevention by the N-methyl-D-aspartate re-ceptor antagonist ketamine. Anesthesiology 2002;96:381–391.

63.Burton AW, Lee DH, Saab C, Chung JM. Preemptive intra-thecal ketamine injection produces a long-lasting decrease in neuropathic pain behaviors in a rat model. Reg Anesth Pain Med 1999;24:208–213.

64.Mao J, Price DD, Hayes RL, Lu J, Mayer DJ, Frenk H. Intrathecal treatment with dextrorphan or ketamine potently reduces pain-related behaviors in a rat model of peripheral mononeu-ropathy. Brain Res 1993;605:164–168.

65.Qian J, Brown SD, Carlton SM. Systemic ketamine attenuates nociceptive behaviors in a rat model of peripheral neuropathy. Brain Res 1996;715:51–62.

66.Rozen TD. Trigeminal neuralgia and glossopharyngeal neural-gia. Neurol Clin 2004;22:185–206.

67.van Kleef M, van Genderen WE, Narouze S, et al. 1. Trigeminal neuralgia. Pain Pract 2009;9:252–259.

68.De Toledo IP, Conti Réus J, Fernandes M, et al. Prevalence of trigeminal neuralgia: A systematic review. J Am Dent Assoc 2016;147:570–576.

69.Younis S, Maarbjerg S, Reimer M, et al. Quantitative senso-ry testing in classical trigeminal neuralgia—A blinded study in patients with and without concomitant persistent pain. Pain 2016;157:1407–1414.

70.Fillingim RB, Maixner W. Gender differences in the responses to noxious stimuli. Pain Forum 1995;4:209–221.

71.Dao TT, LeResche L. Gender differences in pain. J Orofac Pain 2000;14:169–184.

72.Dong XD, Mann MK, Kumar U, et al. Sex-related differences in NMDA-evoked rat masseter muscle afferent discharge re-sult from estrogen-mediated modulation of peripheral NMDA receptor activity. Neuroscience 2007;146:822–832.

73.Fischer L, Torres-Chávez KE, Clemente-Napimoga JT, et al. The influence of sex and ovarian hormones on temporomandib-ular joint nociception in rats. J Pain 2008;9:630–638.

74.Wong H, Dong XD, Cairns BE. Nerve growth factor alters the sensitivity of rat masseter muscle mechanoreceptors to NMDA receptor activation. J Neurophysiol 2014;112:2275–2282.

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