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Nitric Oxide Inhibition by Methylene Blue in the Treatment of Neuropathic Pain : A preliminary report

Adriana Miclescu,Martin Svahn,Torsten Gordh-2012-01-01
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TL;DRAbstract

Methylene blue (MB) is a diaminophenothiazine with potent antioxidant properties and with inhibitory effects on both nitric oxide synthases and on the enzyme guanylate cyclase. It was recently demonstrated that MB reduces chronic discogenic low back pain, pain after lateral sphincterotomy as well as pain on injection of propofol. The underlying mechanisms of MB treatment in the above clinical pain conditions are not completely understood. Given that NMDA receptor is implicated in hyperalgesia and many of the NMDA effects are mediated through the production of nitric oxide we hypothesized that administration of a nitric oxide antagonist would decrease the pain scores and hyperalgesia in neuropathic pain.The aims of the studyWe performed a prospective clinical trial consisting of a double-blinded, crossed-over, randomized clinical trial (RCT). The aim is to determine the clinical effectiveness of methylene blue in the treatment of neuropathic pain.Material and methods Patients with perip

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Methylene blue (MB) is a diaminophenothiazine with potent antioxidant properties and with inhibitory effects on both nitric oxide synthases and on the enzyme guanylate cyclase. It was recently demonstrated that MB reduces chronic discogenic low back pain, pain after lateral sphincterotomy as well as pain on injection of propofol. The underlying mechanisms of MB treatment in the above clinical pain conditions are not completely understood. Given that NMDA receptor is implicated in hyperalgesia and many of the NMDA effects are mediated through the production of nitric oxide we hypothesized that administration of a nitric oxide antagonist would decrease the pain scores and hyperalgesia in neuropathic pain.The aims of the studyWe performed a prospective clinical trial consisting of a double-blinded, crossed-over, randomized clinical trial (RCT). The aim is to determine the clinical effectiveness of methylene blue in the treatment of neuropathic pain.Material and methods Patients with perip

Keywords

Neuropathic painAnesthesiaMethylene blueNitric oxideHyperalgesiaMedicinePharmacologyNociception

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