In this issue of the Scandinavian Journal of Pain, Ethem Akural and coworkers  report pain relieving effect of peripheral morphine after surgical removal of third molars from inflamed tissue. The authors compared morphine 2 mg injected locally with intra-muscular injection. Their analyses indicated that morphine produced better pain relief when injected locally into inflamed tissue around the molar-bed, compared with morphine injected systemically into a muscle. The effect appeared to depend on local inflammation because they did not observe this analgesic effect of morphine injected into non-inflamed tissue. The classification of tissue with an inflammatory or a non-inflammatory reaction was made prior to randomization. The most prominent difference in pain relief appeared between 2 and 6 h after the surgical intervention.1Peripheral analgesic effects of morphineThe concept of injecting morphine into loco dolenti was presented by the Finnish professor Knut Felix von Willebrand as early as 1876 . He focused on the undesirable opioid side effects of systemically administered morphine, and he presented four case reports that indicated that morphine should be administered into the painful tissue. About 100 years later peripheral antinociceptive effect of morphine was demonstrated after subcutaneous injection of prostaglandin E2 in rats , and the
Scandinavian Journal of Pain – de Gruyter
Published: Apr 1, 2016
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