In this issue of the Scandinavian Journal of Pain, Fischer and coworkers  review several methods available for objective measurement of the central nervous system (CNS) effects of opioids and opioid induced analgesia, both at the spinal and the supraspinal levels. This is an important issue as objective, quantifiable markers for opioid analgesia would be of utmost importance both in basic research and drug development, as well as in the assessment of therapeutic efficacy and drug resistant pain conditions in the clinic. Nevertheless, clinical trials mostly rely on subjective reports on the pain estimated with visual analogue scale (VAS) or numerical rating scale (NRS). The task to reduce the subjective, multidimensional experience of pain to objective biomarkers is challenging. This review  ambitiously tackles the problem showing many potential tools already available for the assessment of central nervous system effects of opioids and their relationship to analgesia but, simultaneously, it highlights the problems and open questions in the field.1The methods available for objective assessment of opioid effectsPupillometry seems to be a reliable and feasible measure to assess central opioid effects even on the chair-side as the authors have previously shown . However, as the pupillary size is controlled by
Scandinavian Journal of Pain – de Gruyter
Published: Jan 1, 2017
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