Department / Division
Anesthesiology / Anesthesiology-Pain Division
Durham, NC 27710
General anesthesiology, chronic pain, ambulatory anesthesia for cosmetic surgery
Analgesic tolerance or habituation has long been the limiting factor in the use of narcotics as an adjuvant in treatment of chronic pain situations. Several investigators have studied the causes for tolerance development in the animal. Only Contreras, et al presented clinically useful information in their study using the mouse model when they proposed that calcium channel blockers may be useful in antagonizing morphine tolerance. Although analgesic tolerance (loss of pain relieving ability) has been well established in using the animal model, few studies have been done using human subjects. In our institution, it has been suggested that analgesic tolerance to the narcotic fentanyl can occur in humans after four hours or less of continuous infusion. The purposes of this prospective crossover study on human volunteers are to document the occurrence of acute tolerance to narcotics in four hours or less during a continuous infusion and to investigate whether Contreras' findings of reversing narcotic tolerance with calcium channel blockers are reproducible in the human. These results could significantly affect management of chronic and acute pain where the use of narcotics is unavoidable. Narcotic response will be tested by experimentally induced pain using the submaximal tourniquet test.
This faculty member has no reported relationships with industry.