Volume 131, Number 4, 313-320, DOI: 10.1007/s002130050298

Modulating effects of a cold water stimulus on opioid effects in volunteers

Kim M. Conley, Alicia Y. Toledano, Jeffrey L. Apfelbaum and J. P. Zacny

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Abstract

The purpose of this study was to characterize the effect of a painful stimulus on morphine and butorphanol effects in healthy non-drug abusing volunteers. Thirteen subjects with no history of opiate dependence participated in a randomized, placebo-controlled, double-blind, crossover trial in which each subject received saline, 2 mg/70 kg butorphanol, and 10 mg/70 kg morphine, IV, in each of two conditions, periodic forearm immersions into either ice-cold water (2°C) or into warm water (37°C). Both opioids reduced self-reported ratings of pain intensity, indicative of analgesia. Several of the subjective effects of morphine were attenuated either during or in between cold-water immersions, including visual analog scale ratings of “coasting (spaced out),”“high (drug “high”),”“sleepy (drowsy, tired),” and “lightheaded”. In contrast, some of butorphanol’s subjective effects were increased by the cold-water manipulation. Morphine impaired psychomotor performance during one of the warm-water immersions, but not during the cold-water immersions. Psychomotor impairment induced by butorphanol was not affected by water temperature. This study provides evidence that opioid effects can be modulated by a painful stimulus in humans.

Key words Morphine - Butorphanol - Subjective - Opiate - Psychomotor - Opioid - Analgesia - Pain - Human

Received: 6 March 1996/Final version: 17 October 1996

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