Lornoxicam characteristically modulates cerebral pain-processing in human volunteers: a functional magnetic resonance imaging study

Br J Anaesth. 2008 Jun;100(6):827-33. doi: 10.1093/bja/aen082. Epub 2008 Apr 21.

Abstract

Background: Lornoxicam like other non-steroidal anti-inflammatory drugs (NSAIDs) is widely used for postoperative pain therapy. Evaluation of the effect of lornoxicam on cerebral processing of surgical pain was thus the aim of the present functional magnetic resonance imaging (fMRI) study.

Methods: An fMRI-compatible pain model that mimics surgical pain was used to induce pain rated 4-5 on a visual analogue scale (VAS) at the anterior margin of the right tibia in volunteers (n=22) after i.v. administration of saline (n=11) or lornoxicam (0.1 mg kg(-1)) (n=11).

Results: Lornoxicam, which significantly reduced pain sensation [VAS: mean (sd) 4.6 (0.7) vs 1.2 (1.5)], completely suppressed pain-induced activation in the SII/operculum, anterior cingulate cortex, insula, parietal (inferior), prefrontal (inferior, medial), temporal (inferior, medial/superior) lobe, cerebellum, and contralateral (e.g. left-sided) postcentral gyrus (SI). Only the hippocampus and the contralateral superior parietal lobe (BA 7) were activated.

Conclusions: As compared with saline, lornoxicam typically suppressed pain-induced brain activation in all regions except the hippocampus. Furthermore, de novo activation was found in the contralateral, superior parietal lobe (BA 7).

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / pharmacology*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Brain / drug effects*
  • Brain / physiopathology
  • Brain Mapping / methods
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Pain / etiology
  • Pain / physiopathology*
  • Pain / prevention & control
  • Pain Measurement / methods
  • Physical Stimulation
  • Piroxicam / analogs & derivatives*
  • Piroxicam / pharmacology
  • Piroxicam / therapeutic use
  • Single-Blind Method

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Piroxicam
  • lornoxicam