An Experimental Itch Model in Monkeys: Characterization of Intrathecal Morphine-induced Scratching and Antinociception

Background: The most common side effect of spinal opioid administration is pruritus, which has been treated with a variety of agents with variable success. Currently, there are few animal models developed to study this side effect. The aim of this study was to establish a nonhuman primate model to pharmacologically characterize the effects of intrathecal administration of morphine. Methods: Eight adult rhesus monkeys were used. Scratching responses were videotaped and counted by observers who were blinded to experimental conditions. Antinociception was measured by a warm-water (50°C) tail-withdrawal assay. The dose–response of intrathecal morphine (1–320 &mgr;g) for both scratching and antinociception in all subjects was established. An opioid antagonist, nalmefene, was administered either intravenously or subcutaneously to assess its efficacy against intrathecal morphine. Results: Intrathecal morphine (1–32 &mgr;g) increased scratching in a dose-dependent manner. Higher doses of intrathecal morphine (10–100 &mgr;g) produced thermal antinociception in a dose-dependent manner. On the other hand, nalmefene (10–32 &mgr;g/kg intravenously) attenuated maximum scratching responses among subjects. Pretreatment with nalmefene (32 &mgr;g/kg subcutaneously) produced approximately 10-fold rightward shifts of intrathecal morphine dose–response curves for both behavioral effects. Conclusions: These data indicate that intrathecal morphine-induced scratching and antinociception are mediated by opioid receptors. The magnitude of nalmefene antagonism of intrathecal morphine is consistent with &mgr; opioid receptor mediation. This experimental itch model is useful for evaluating different agents that may suppress scratching without interfering with antinociception. It may also facilitate the clarification of mechanisms underlying these phenomena.

[1]  S. Emerson,et al.  Dose-response relationship of intrathecal morphine for postcesarean analgesia. , 1999, Anesthesiology.

[2]  A. Borgeat,et al.  Ondansetron is effective to treat spinal or epidural morphine-induced pruritus. , 1999, Anesthesiology.

[3]  D. Moriarty,et al.  The effect of intravenous tenoxicam on pruritus in patients receiving epidural fentanyl , 1999, Anaesthesia.

[4]  S. Ho,et al.  Comparison of Intravenous Nalbuphine Infusion Versus Naloxone in the Prevention of Epidural Morphine‐Related Side Effects , 1998, Regional anesthesia and pain medicine.

[5]  J. Woods,et al.  The role of peripheral mu opioid receptors in the modulation of capsaicin-induced thermal nociception in rhesus monkeys. , 1998, The Journal of pharmacology and experimental therapeutics.

[6]  H. Mosberg,et al.  kappa-Opioid receptor binding populations in rhesus monkey brain: relationship to an assay of thermal antinociception. , 1998, The Journal of pharmacology and experimental therapeutics.

[7]  J. Woods,et al.  Differentiation of kappa opioid agonist-induced antinociception by naltrexone apparent pA2 analysis in rhesus monkeys. , 1998, The Journal of pharmacology and experimental therapeutics.

[8]  C. Tohda,et al.  Intracisternal injection of opioids induces itch-associated response through mu-opioid receptors in mice. , 1997, Japanese journal of pharmacology.

[9]  P. Kam,et al.  Pruritus—itching for a cause and relief? , 1996, Anaesthesia.

[10]  M. Greaves,et al.  Pathophysiology of itching , 1996, The Lancet.

[11]  E. Dunteman,et al.  Transnasal butorphanol for the treatment of opioid-induced pruritus unresponsive to antihistamines. , 1996, Journal of pain and symptom management.

[12]  Division on Earth Guide for the Care and Use of Laboratory Animals , 1996 .

[13]  M. Chaney Side effects of intrathecal and epidural opioids , 1995, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[14]  C. France,et al.  Behavioral effects of 6-methylene naltrexone (nalmefene) in rhesus monkeys. , 1994, The Journal of pharmacology and experimental therapeutics.

[15]  P. Suter,et al.  Epidural-morphine-induced pruritus: propofol versus naloxone. , 1994, Anesthesia and analgesia.

[16]  J. Woods,et al.  In vivo determination of mu opioid receptor turnover in rhesus monkeys after irreversible blockade with clocinnamox. , 1994, The Journal of pharmacology and experimental therapeutics.

[17]  J. Woods,et al.  Effects of opioid agonists selective for mu, kappa and delta opioid receptors on schedule-controlled responding in rhesus monkeys: antagonism by quadazocine. , 1993, The Journal of pharmacology and experimental therapeutics.

[18]  D. A. Thomas,et al.  Multiple effects of morphine on facial scratching in monkeys. , 1993, Anesthesia and analgesia.

[19]  J. Woods,et al.  Opioid thermal antinociception in rhesus monkeys: receptor mechanisms and temperature dependency. , 1993, The Journal of pharmacology and experimental therapeutics.

[20]  D. A. Thomas,et al.  The Medullary Dorsal Horn: A Site of Action of Morphine in Producing Facial Scratching in Monkeys , 1993, Anesthesiology.

[21]  J. Woods,et al.  Prostaglandin E2-induced thermal hyperalgesia and its reversal by morphine in the warm-water tail-withdrawal procedure in rhesus monkeys. , 1993, The Journal of pharmacology and experimental therapeutics.

[22]  N. Pace,et al.  Dose‐Response Pharmacology of Intrathecal Morphine in Human Volunteers , 1993, Anesthesiology.

[23]  N. Bergasa,et al.  The pruritus of cholestasis and the opioid system. , 1992, JAMA.

[24]  E. Ratner,et al.  Nalbuphine is better than naloxone for treatment of side effects after epidural morphine. , 1992, Anesthesia and analgesia.

[25]  D. A. Thomas,et al.  Effects of central administration of opioids on facial scratching in monkeys , 1992, Brain Research.

[26]  B. Långström,et al.  Distribution of 11C-Labelled Morphine and Pethidine After Spinal Administration to Rhesus Monkey , 1989 .

[27]  B. Långström,et al.  Distribution of11 C–labelled morphine and pethidine after spinal administration to Rhesus monkey , 1989, Acta anaesthesiologica Scandinavica.

[28]  R. Sebaldt Manual of Pharmacologic Calculations with Computer Programs. Second Edition , 1988 .

[29]  T. Yaksh,et al.  Pharmacology of the allodynia in rats evoked by high dose intrathecal morphine. , 1988, The Journal of pharmacology and experimental therapeutics.

[30]  J. Brock‐Utne,et al.  Cisternal cerebrospinal fluid concentrations of morphine following intrathecal and epidural administration in the baboon. , 1988, Anaesthesia and Intensive Care.

[31]  L. Dykstra,et al.  A tail withdrawal procedure for assessing analgesic activity in rhesus monkeys. , 1986, Journal of pharmacological methods.

[32]  T. Gal,et al.  Prolonged Antagonism of Opioid Action with Intravenous Nalmefene in Man , 1985, Anesthesiology.

[33]  M. Max,et al.  Epidural and intrathecal opiates: Cerebrospinal fluid and plasma profiles in patients with chronic cancer pain , 1985, Clinical pharmacology and therapeutics.

[34]  R. Tallarida,et al.  Manual of Pharmacologic Calculations: With Computer Programs , 1984 .

[35]  L. Mather,et al.  Intrathecal and epidural administration of opioids. , 1984, Anesthesiology.

[36]  T. Yaksh In vivo studies on spinal opiate receptor systems mediating antinociception. I. Mu and delta receptor profiles in the primate. , 1983, The Journal of pharmacology and experimental therapeutics.

[37]  P. Bromage,et al.  Rostral Spread of Epidural Morphine , 1982, Anesthesiology.

[38]  T. Yaksh,et al.  Studies in the primate on the analgetic effects associated with intrathecal actions of opiates, alpha-adrenergic agonists and baclofen. , 1981, Anesthesiology.

[39]  A. Baraka,et al.  Intrathecal Injection of Morphine for Obstetric Analgesia , 1981, Anesthesiology.

[40]  John E. Thomas,et al.  Pain relief by intrathecally applied morphine in man. , 1979, Anesthesiology.