Evidence for analgesia mediated by peripheral opioid receptors in inflamed synovial tissue

Eur J Clin Pharmacol. 1992;43(4):351-5. doi: 10.1007/BF02220608.

Abstract

Intra-articular morphine (5 mg in 25 ml) was administered to patients for post-operative analgesia following arthroscopic knee surgery. At various time intervals, 30 min to 4 h post morphine, venous blood samples were taken in order to determine plasma levels of morphine and its primary metabolites, morphine-3-glucuronide and morphine-6-glucuronide. Measurable amounts of morphine and morphine-3-glucuronide were found in the plasma of 7/10 patients whereas morphine-6-glucuronide was detected in only 2/10 patients. The plasma levels of morphine were lower than that regarded sufficient for post-operative analgesia in all but two patients, indicating a possibility of peripheral analgesia. In addition, synovial biopsy samples were assayed for the presence of opioid binding sites. Tissue samples from 11 different patients were analysed and 6/11 exhibited specific binding of [3H]naloxone, indicating the presence of opioid binding sites/receptors. The receptor type (i.e. mu-, delta- or k-) is at present unknown. Taken together, these data provide evidence that locally administered opiates can act on specific opioid receptors in the synovium to mediate analgesia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analgesia*
  • Arthroscopy / adverse effects
  • Female
  • Humans
  • Knee / surgery
  • Male
  • Morphine / blood
  • Morphine / pharmacology*
  • Morphine Derivatives / blood
  • Pain, Postoperative / drug therapy*
  • Radioligand Assay
  • Receptors, Opioid / drug effects*
  • Receptors, Opioid / metabolism
  • Synovitis / blood
  • Synovitis / metabolism*

Substances

  • Morphine Derivatives
  • Receptors, Opioid
  • morphine-6-glucuronide
  • Morphine
  • morphine-3-glucuronide