Efficacy and mechanism of combination therapy with pulsed radiofrequency and tramadol for neuropathic pain.

2020 Fiscal Year Final Research Report

• Project/Area Number: 18K16455
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55050:Anesthesiology-related
• Research Institution: University of Miyazaki
• Principal Investigator: HIDAKA KOTARO 宮崎大学, 医学部, 助教 (20750392)
• Project Period (FY): 2018-04-01 – 2021-03-31
• Keywords: 高周波パルス療法 / Tramadol / Resiniferatoxin / ERK / NaV1.7

Outline of Final Research Achievements

The efficacy of the combined therapy of pulsed radiofrequency (PRF) and repeated administration of tramadol was investigated using neuropathic pain model rats prepared by resiniferatoxin (RTX) administration. RTX lowered the threshold for mechanical stimulation and PRF restored it. Although PRF at 5 weeks of RTX administration had no effect, repeated administration of tramadol also restored the threshold value of PRF at 5 weeks. In the dorsal root ganglion (DRG), RTX showed ERK phosphorylation and increased Nav1.7 expression. These were suppressed by PRF.

Free Research Field

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Academic Significance and Societal Importance of the Research Achievements

パルス高周波療法(Pulsed radiofrequency: PRF)は組織障害が少なく、かつ長期の鎮痛が得られる治療法であるが、神経障害性疼痛発症から時期がたつと有効性が低下することがある。また、臨床的には第一選択として用いられることは少なく、薬物療法が先行して行われている。本研究により、Tramadolが投与されている患者にはPRFが有効となる可能性が高いことが示され、発症から時期が経っていても治療の選択肢となると考えられる。