Differential Effect of Capsaicin Treatment on Pain-Related Behaviors After Plantar Incision
Abstract
We evaluated the effect of infiltration of dilute solutions of capsaicin, administered before plantar incision, on 3 pain-related behaviors: guarding pain, heat-withdrawal latency, and mechanical-withdrawal threshold. Perineural application of capsaicin was also studied and the appearance of the wound was also evaluated. Dilute solutions of capsaicin .025% and .10% were infiltrated in the plantar region 1 day before incision. In another group of rats, perineural capsaicin (1%) was applied to the nerves innervating the plantar aspect of the rat hindpaw. Rats were then tested for pain-related behaviors before and after plantar incision and then daily thereafter. Wound appearance was graded and histopathology was evaluated. Infiltration with capsaicin reduced guarding pain and heat hyperalgesia after plantar incision; there were minimal effects on mechanical responses. Perineural-capsaicin application produced a similar result. Both capsaicin infiltration and perineural-capsaicin application impaired wound apposition. Histologic evaluation also confirmed impaired wound apposition after capsaicin infiltration. In conclusion, dilute solutions of capsaicin have differential effects on pain-related behaviors after plantar incision. Based on the antinociception produced by capsaicin both via infiltration and perineural injection, the effect on wound appearance was likely related to its inhibitory effects on pain behaviors and was not necessarily a local effect of the drug.
Perspective
This study demonstrated that capsaicin infiltration before plantar incision produced an analgesic effect that depended upon the stimulus modality tested. When evaluating novel treatments for postoperative pain, studies using a single stimulus modality may overlook an analgesic effect by not examining a variety of stimuli.
Key words: Postoperative, hyperalgesia, vanilloid, peripheral sensitization, heat
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Supported by a grant from University of Iowa to Dr. Gerald F. Gebhart, by Academy of Finland and Oskar Oflund stiftelse to Dr. M.M.H., and by National Institutes of Health, Bethesda, Maryland grants GM-55831 and GM-067752 to T.J.B.
The authors are not aware of any potential conflicts of interest. Dr. Brennan has served as a consultant to Anesevia, manufacturer of Adlea (capsaicin) after the completion of the studies. The authors are grateful for the technical assistance of Sung Kung Lee, M.D. and Jason Kruger, M.D.
PII: S1526-5900(09)00012-1
doi:10.1016/j.jpain.2009.01.003
© 2009 American Pain Society. Published by Elsevier Inc. All rights reserved.
