Increased opioid analgesic (OA) prescribing has been associated with increased risk of prescription opioid diversion, misuse, and abuse. States established prescription drug monitoring programs (PDMPs) to collect and analyze electronic records for dispensed controlled substances to reduce prescription drug abuse and diversion. PDMP data can be used by prescribers for tracking patient’s history of controlled substance prescribing to inform clinical decisions. The studies in this dissertation are focused on the less utilized potential of the PDMP data to enhance public health surveillance to monitor OA prescribing and co-prescribing and association with opioid overdose mortality and morbidity. Longitudinal analysis of OA prescribing and evaluation of the effect of recent policies and opioid prescribing guidelines require consensus measures for OA utilization and computational tools for uniform operationalization by researchers and agencies. Statistical macros and computational tools for OA utilization measures were developed and tested with Kentucky PDMP data. A set of covariate measures using mortality and morbidity surveillance data were also developed as proxy measures for prevalence of painful conditions justifying OA utilization, and availability of heroin and medication treatment for opioid use disorder. A series of epidemiological studies used the developed OA measures as outcomes, and adjusted for time-varying socio-demographic and health care utilization covariates in population-averaged statistical models to assess longitudinal trend and pattern changes in OA utilization in Kentucky in recent years. The first study, “Trends and Patterns of OA Prescribing: Regional and Rural-Urban Variations in Kentucky from 2012 to 2015,” shows significant downward trends in rates of residents with OA prescriptions. Despite the significant decline over time, and after accounting for prevalence of injuries and cancer, the rate of dispensed OA prescriptions among residents in Kentucky Appalachian counties remained significantly higher than the rest of the state. The second study, “Population-Level Measures for High-Risk OA Prescribing: Longitudinal Trends and Relationships with Pain-Associated Conditions,” shows significant reduction in high-risk OA prescribing (e.g., high daily dosage, long-term use, concurrent prescriptions for OA and benzodiazepines) from 2012 to 2016, significantly positive associations between high-risk OA prescribing and cancer mortality rates with no substantial change in the association magnitude over time, and declining strengths of positive associations between high-risk OA prescribing and acute traumatic injuries or chronic non-cancer pain over the study period. The third study, “A Reciprocal Association between Longitudinal Trends of Buprenorphine/Naloxone Prescribing and High-Dose OA Prescribing,” indicates a significant reciprocal relationship between high-dose OA prescribing and buprenorphine/ naloxone prescribing, and a clinically meaningful effect of buprenorphine/naloxone prescribing on reducing OA utilization. The results from the studies advanced the understanding of the epidemiology of opioid use and misuse in Kentucky, and identified actionable risk and protective factors that can inform policy, education, and drug overdose prevention interventions. The developed operational definition inventory and computational tools could stimulate further research in Kentucky and comparative studies in other states.

Opioid overdose fatalities have quadrupled in the United States since the turn of the century, and are becoming increasingly recognized as a nationwide epidemic. While naloxone (narcan) has long been the standard treatment for overdose in clinical settings, it has not been issued to opioid users or their family members in the U.S. until relatively recently. As naloxone distribution and overdose training become more widespread, they are being incorporated into more and more abstinence-oriented settings including detoxes, halfway houses, and outpatient methadone and suboxone treatment programs. This qualitative study explored whether the staff at such programs found that training their patients to use naloxone was disruptive or controversial, and whether they found it difficult to reconcile these trainings’ basis in harm reduction with their personal and organizational philosophies about substance use and recovery. Ten subjects from Eastern and Central Massachusetts were interviewed about their experience introducing naloxone to their patients under the aegis of the Massachusetts Department of Public Health’s Opioid Overdose Prevention Pilot Program, and their interviews were analyzed from a descriptive phenomenological perspective. This approach seeks to distill the essence of a phenomenon by analyzing the narratives of those who have experienced it, and has been found especially useful when exploring questions that have not yet been studied in depth. The analysis identified eleven recurring themes, grouped into four broad domains (What is overdose prevention training? What is narcan? What is harm reduction? What is the goal of treatment?). These themes suggested that while subjects overwhelmingly experienced naloxone distribution and overdose prevention training as positive additions to their workplace, this experience did not necessarily lead to more engagement with the broader concept of harm reduction.

The aim of the thesis was to analyze the historical pharmaceutical preparations, including the determination of the active substance and identify theirs possible degradation products. A historical pharmaceutical preparation of naloxone was analyzed by mass spectrometry. Historical pharmaceutical preparations of adrenaline and ephedrine were analyzed by UHPLC-MS and were quantified using a calibration curve. In the historical injection solution of naloxone, "NARCAN", dated around 1980, there were no significant degradation products and the measured mass and UV spectrum was consistent with the spectrum of naloxone. The analyzed sample of naloxone was stable even after 35 years of storage. In the analyzed historical injection solution of adrenaline, "Adrenalin Hydrochlor., Dr. Heisler" (dated between 1917 and 1938) was determined 5.26 ± 0.11 % of the declared amount of adrenaline. In the measured spectras were noticeable degradation products, which have not been described in the literature yet and their identification was beyond the scope of this paper. The analyzed sample of adrenaline was almost completely degraded during about ninety years. The stability test carried out with four standard solutions of adrenaline proved influence of oxygen, light, temperature and time on the degradation of adrenaline. In...

No description available.

The ongoing overdose problem in the United States, particularly exacerbated by the widespread use of fentanyl, and polydrug use, represents a critical public health challenge. This thesis explores how people who use drugs (PWUD) in Orlando, Florida, are responding to the overdose problem in their community. Drawing on ethnographic research conducted at a syringe services program in Summer 2023, I argue that PWUD in Orlando actively take measures to prevent overdose and overdose deaths but are faced with many obstacles that challenge their overdose prevention efforts. I examine overdose narratives of PWUD to show how factors preventing effective overdose prevention are not just systemic but also cultural. In particular, the prevailing stigma of opioid use hinders the creation of a supportive environment for preventing overdoses and perpetuates the ostracization of PWUD in Orlando. Recognizing the profound influence of stigma towards the PWUD with whom I conducted research, I make the case for reimagining overdose prevention as a comprehensive effort in Orlando to equip PWUD, their families, first responders, and the broader community with the knowledge, skills, and tools to address overdose. Such efforts also have the potential to recalibrate cultural misconceptions and biases toward PWUD. As Florida and the nation continue to experience an overdose problem, understanding local cultural and structural challenges remains pivotal. This project demonstrates that by integrating comprehensive training and combating stigmatization of PWUD, Orlando communities can prevent overdose and save lives more effectively.

INTRODUÇÃO: Tramadol é conhecido como um fármaco analgésico de ação central utilizado no tratamento de dores de intensidades moderada a forte. Efeito analgésico local já foi demonstrado. É, em parte, semelhante ao efeito anestésico local, mas outros mecanismos permanecem desconhecidos. O papel de receptores opioides periféricos na analgesia do tramadol na dor pós-operatória não é conhecido. Neste estudo, foi estudado o papel dos receptores opioides no efeito analgésico local do tramadol em modelo de dor por incisão plantar. MÉTODOS: Ratos machos jovens foram submetidos à incisão plantar e no primeiro dia pós-incisão foram divididos em quatro grupos: Grupo IP I-SF/SF - 50 uL de solução de NaCl 0,9% foram injetados na região plantar da pata posterior homolateral à incisão e, 15 minutos depois, novamente injetada a mesma quantidade de solução; Grupo IP II-SF/T_homo - 50 uL de NaCl 0,9% foram injetados na região plantar da pata homolateral e, 15 minutos depois, injetados 50 µL solução contendo 5 mg tramadol; Grupo IP III-SF/T_contra -50 uL de NaCl 0,9% foram injetados na região plantar da pata contralateral e, 15 minutos depois, 50 uL de solução contendo 5 mg de tramadol; Grupo IP IV-Nal/T_homo - 50 uL de solução contendo 200 ug de naloxona foram injetados na pata homolateral e, 15 minutos depois, 50 uL de solução contendo 5mg de tramadol foi injetada. Antes de receberem as injeções, os limiares de retirada da pata por estímulo mecânico produzido por analgesímetro eletrônico de von Frey foram medidos, e, depois da administração dos fármacos, os limiares de retirada foram avaliados nos tempos 15, 30, 45 e 60 minutos após a administração dos fármacos. O mesmo procedimento foi utilizado no segundo dia pós-incisão. As expressões proteicas dos receptores opioide ? (DOR) e µ (MOR) foram avaliadas usando técnica de immunoblotting de gânglios de raízes dorsais homolaterais (L3, L4, L5 e L6) de grupos de animais sem incisão e após 1, 2, 3 e 7 dias de animais submetidos à incisão plantar. RESULTADOS: A incisão plantar gerou marcada hiperalgesia mecânica que foi revertida por tramadol intraplantar nos dois dias. O tramadol intraplantar em pata contralateral não antagonizou a hiperalgesia mecânica, a naloxona antagonizou parcialmente o efeito analgésico do tramadol no primeiro dia pós-incisão, e antagonizou completamente no segundo dia pós-incisão. A expressão proteica de DOR aumentou no 2º, 3º e 7º dias pós-incisão, a expressão de MOR não se modificou. CONCLUSÕES: O tramadol apresentou efeito analgésico local após estímulo mecânico e esse efeito foi antagonizado por naloxona no segundo dia pós-incisão. A expressão de DOR aumentou após a incisão plantar / BACKGROUND: Tramadol is known as a central acting analgesic drugused for the treatment of moderate to severe pain. Local analgesic effect was already demonstrated. It is in part due to local anesthetic-like effect, but other mechanisms remain unclear. The role of peripheral opioid receptors in the local analgesic effect in postoperative pain is not known. In this study, we examined the role of peripheral opioid receptors in the local analgesic effect of tramadol in the plantar incision pain model. METHODS: Young male Wistar rats were submitted to plantar incision and in the first postoperative day (POD1) were divided into four groups:IP I-SF/SF,50 uL of 0.9% NaCl solution were injected in the plantar aspect of the homolateral hindpaw and again after 15 minutes; IP II-SF/T_homo, 50 uL of 0.9% NaCl solution were injected in the plantar aspect of the homolateral hindpaw and, 15 minutes later, 50 µL of solution containing 5 mg tramadol were injected in the same hindpaw; IP III-SF/T_contra, 50 uL of 0.9% NaCl were injected in the plantar aspect of the contralateral hindpaw and, 15 minutes later, 50 uL of solution containing 5 mg tramadol were injected in the same hindpaw; IP IVNal/T_homo, 50 uL of naloxone (200 ug) solution were injected in the homolateral hindpaw and 15 minutes later 50 µL of solution containing 5 mg tramadol were injected. Before receiving the assigned drugs, baseline withdrawal thresholds for mechanical hyperalgesia using electronic von Frey were measured, then, after receiving the assigned drugs, withdrawal thresholds were measured at 15, 30, 45 and 60 min after drug injection. The same procedure was repeated in POD2. u opioid receptor (MOR) and opioid receptor (DOR) protein expressions were evaluated using immunoblotting after removal of ipsilateral dorsal root ganglia (L3, L4, L5 and L6) in groups of rats non submitted to plantar incision and 1, 2, 3 and 7 days after incision. RESULTS: Plantar incision led to marked mechanical hyperalgesia that was reversed with intraplantar tramadol in both days. Contralateral tramadol did not affect mechanical hyperalgesia and naloxone antagonized partially intraplantar tramadol in POD1, and antagonized completely in POD2. DOR expression in DRGs increased in POD2, POD3 and POD7, MOR expression did not change. CONCLUSIONS: Tramadol presented local analgesic effect after mechanical stimuli and this effect was antagonized by naloxone in the second post incision day. DOR increased expression after plantar incision

A reduction in voluntary feed intake is a major factor in the lost productivity of grazing lambs infected by gastrointestinal parasites yet the mechanisms involved are poorly understood. Potential pathways involved in parasite-induced feed intake depression were investigated in lambs with minimal previous exposure to parasites and artificially infected by the small intestinal parasite Trichostrongylus colubriformis. Six in vivo experiments were conducted on lambs housed in individual pens or metabolism crates with similar feeding and experimental procedures. In Experiment 1 (Chapter 4) the effect of T. colubriformis infection on short term feed intake in lambs and of some pharmacological agents on feed intake depression were investigated. Prior to and for the duration of infection, lambs were fed once per day and feed intake recorded at regular intervals over the day (8 h). Following the onset of feed intake depression in the infected group (9 weeks after commencing dosing), all animals were treated with an analgesic (codeine phosphate per os), an anti-inflammatory agent (indomethacin per os), a CCK antagonist (L364-718 by subcutaneous injection) or saline (control) in a replicated Latin square design (n = 8). Although the pattern of feed consumption was similar in infected and non-infected lambs, average daily intake was reduced 32 % and short term intake (recorded at 10 minute intervals for the first hour of feeding, 15 minute intervals for the second hour and hourly for the next 6 hours of feeding) reduced 40 % by infection. This identified the key component by which intake was depressed and enabled the use of a short term intake model and short duration of action compounds to identify the pathways involved in intake depression in this sequence of experiments. None of the pharmacological treatments increased intake in the infected group. These results suggest a reduction in the rate of consumption due to reduced hunger signals, rather than change of meal eating patterns, is the major cause of feed intake depression. Specific conclusions about the pathways investigated using the pharmacological agents could not be obtained. Experiment 2 (Chapter 5) was designed to investigate the roles of pain and osmolality on feed intake depression. Digesta samples collected prior to and during parasite infection and before and after feeding had similar osmolalities (240-260 mosmol/l) which indicated that feeding or infection had no effect on osmolality of digesta. Following the onset of feed intake depression in infected animals, all animals were treated in a Latin square design (n = 4) with no treatment, saline, local anaesthetic (xylocaine) or analgesic (codeine phosphate) solution 15 minutes before feeding, by slow injection into the duodenum. There was no effect of these treatments on food intake. In the second part of the experiment, hyperosmotic solutions (mannitol and NaCI) markedly depressed short term intake in non-infected animals, suggesting a role for osmoreceptors in intake regulation. However these effects were not blocked by local anaesthetic so the depressed intake may have resulted from generalised malaise rather than from specific osmoreceptor effects. In Experiment 3 (Chapter 6) the role of peripheral CCK on intake depression was examined by a dose-response study utilising the CCK antagonist, loxiglumide. Intravenous injection of 5, 10 or 20 mg/kg LW of loxiglumide to infected lambs 10-15 minutes before feeding (n = 6) had no effect on feed intake at any of the dose levels. In experiment 4 (Chapter 7) loxiglumide was infused intravenously for 10 minutes (30 mg/kg/h) before feeding and for the first 2 h (10 mg/kg/h) after feed was offered to minimise any effect of the rate of clearance of loxiglumide on the lack of feed intake response. As well, the rate of marker disappearance from the abomasum was recorded in both infected and non-infected animals. Continuous infusion of loxiglumide did not attenuate parasite induced intake depression nor did it have any effect on abomasal emptying. Abomasal volume was reduced by infection (66.3 vs 162 ml) as was the fractional outflow rate (2.2 vs 2.8 ml/min) but these differences were accounted for by the lower level of feed intake in the infected animals. In Experiment 5 (Chapter 8) brotizolam, a benzodiazepine appetite stimulant, thought to act on the hypothalamus, was administered in a dose-response study to infected and non-infected animals (n = 4) immediately prior to feeding or following termination of the first meal (45 minutes after feeding) and the feed intake response recorded. Brotizolam elevated both the short term (0-0.75 h), daily (22 h) intake and all time intervals in the first 5 h after feeding in infected and non-infected animals when administered after the first meal but when administered prior to feeding elevated intake only over the first 6 h of feeding. In both cases the magnitude of the response was greater in infected animals than in non-infected animals. Brotizolam appeared to increase the rate of eating without having a major impact on meal eating patterns when administered before feeding. Where administration was after the first meal, the effect was due to an "extra" meal being consumed. These findings showed that infected animals can respond to central stimulators of intake although the mechanism of the response is not known. Opioids were implicated in intake depression as the rate of intake rather than meal patterns appeared to be the major parameter depressed under parasitism. This was examined in experiment 6 (Chapter 9) where animals (n = 6) were fasted for 26 h or not fasted, then treated with saline (control), brotizolam (intake stimulant) or naloxone (opioid antagonist) immediately prior to feeding. Fasting stimulated feed intake in the short term (100 % increase in 75 min) and over the day (12 % increase) in both infected and non-infected animals. Following fasting, infected animals ate a similar amount of feed to the non-infected, fasted animals and more than the non-infected, non-fasted animals. The signals resulting from a one day fast were sufficient in the short term to override parasite induced mechanisms causing feed intake depression. Naloxone suppressed the intake stimulatory effects of a 26 h fast in both infected and non-infected animals, which supports a role for endogenous opioids as hunger signals. Where animals were not fasted, naloxone reduced intake only in the non-infected animals which suggested endogenous opioid levels may be lower in infected animals than in non-infected animals. In the final experiment (Experiment 7, Chapter 10) the role of central hunger and satiety mechanism were investigated. Infected and non-infected animals (n = 6) were treated with naloxone or saline by intravenous injection, or saline and met-enkephalinamide (an opioid analogue) by intracerebral infusion, or naloxone and the opioid analogue simultaneously to investigate the role of central opioids in feed intake depression. To determine the role of CCK induced satiety signals on feed intake at a central level, loxiglumide and CCK were infused separately and in combination for 30 minutes prior to feeding and for the first 60 minutes of feed on offer, into a lateral cerebral ventricle of the brain of infected and control animals (n = 6). The opioid analogue tended to increase intake in infected animals but the effect was not significant probably because the dose used was too low to elicit a response in sheep. Naloxone depressed intake only in the infected animals, which conflicted with the results of Experiment 4. As a consequence these results were inconclusive because of the single low dose of opioid analogue used and the conflicting naloxone responses. CCK alone depressed intake by 39-52 % only in infected animals and this effect of the 90 minute infusion was evident over the 8 h short term recording period. Loxiglumide attenuated the feed intake depressive effects of CCK in the infected animals to the extent that intake was elevated above control levels. Loxiglumide alone was an intake stimulant in both infected and non-infected animals. Intake was increased over the entire 8 h but mostly in the second hour when intake was increased by 188 % in infected animals and by 16 % in the non-infected animals and resulted in almost continuous eating. These results showed loxiglumide will temporarily block the effect of parasite infection on feed intake in sheep when administered centrally and the fact that it blocked the effects of exogenous CCK on intake indicated that the effect is mediated via CCK receptors. In conclusion GIT parasite infection reduced both short term and daily feed intake apparently by a change in rate of intake rather than any alteration in meal patterns. It was further suggested that anyone of a number of potential peripheral pathways, including changes to osmolality, gut emptying, pain and inflammation of the gut, alone is not involved in anorexia in sofar as the compounds used could block these factors and the results support the idea that intake depression is mediated via a central mechanism. Intake in infected animals responded to a much greater extent when fasting, i.c.v. loxiglumide or brotizolam were employed. Feed intake thus appears to be regulated through the same mechanisms in infected and non-infected animals. The results from compounds affecting the central mechanism suggest central CCK receptors are important in parasite induced anorexia, possibly by changing the onset of satiety or by interacting with endogenous opioids to reduce the rate of feed intake. Secondly reduced endogenous opioids may be causing the reduction in the rate of feed consumption alone or as a result of other interactions. It was concluded that intake in parasitised animals could be increased to that of control animals by employing procedures and compounds thought to act on the hypothalamus.

O mecanismo do efeito sedativo da clonidina (CLO), um agonista α2-adrenérgico não é claro. Como a ativação dos receptores α2-adrenérgicos induz a liberação de Óxido Nítrico (NO) das células endoteliais, testamos a hipótese de que o efeito sedativo e antinociceptivo da CLO sistêmica dependeria de mecanismos relacionados a via NOGMPc. O 7-NI reduziu significativamente o tempo de sono induzido pela clonidina. O tempo de sono induzido pelo tiopental (TST) foi aumentado pela CLO, α-metildopa, rilmenidina (RIL) and midazolam. O L-NAME reduziu o prolongamento do TST da CLO, α-metildopa, RIL, sem alterar o efeito do midazolam. O efeito inibitório do L-NAME no prolongamento do TST com a CLO foi revertido pela L-arginine. Os resultados sugerem mecanismos NO-dependentes no efeito sedativo da clonidina. Esses efeitos parecem ser específicos para a ação sedativa dos agonistas α2-adrenérgicos. Avaliamos também a possível ligação envolvendo opóides e a via do NO-GMPc no efeito antinociceptivo da CLO. O efeito antinociceptivo induzido pela administração sistêmica de CLO e RIL foi avaliado utilizando o teste das contorções abdominais em camundongos e o teste tailflick. A CLO (3120 g/kg) and RIL induziram efeito antinociceptivo dose-dependente no teste das contorções abdominais e TFL. O efeito antinociceptivo da CLO foi significativamente reduzido pela inibição da NO-syntase and guanylyl ciclase. O efeito da RIL também foi reduzido pelo 7-NI. O efeito antinociceptivo da morfina foi inibido pela naloxona, que não inibiu o efeito da CLO. Nossos resultados sugerem que o efeito da CLO sistêmica não envolve receptor opióide e é modulado por uma via NO-GMPc. / The mechanism of sedative effect of clonidine (CLO), an α2-adrenoceptor agonist remain unclear. As the activation of α2-adrenoceptors induces release of nitric oxide (NO) from endothelial cells, which has led us to test the hypothesis that sedative and antinociceptive effect from systemic CLO depends on the NO-cGMP pathway mechanisms. The sleeping time in rats induced by CLO was significantly decreased by 7-NI. Thiopental sleeping time (TST) was increased by CLO, α-methyldopa, rilmenidine (RIL) and midazolam. L-NAME reduced the prolongation effect of clonidine, α-methyldopa, RIL, but did not alter the effect of midazolam on the TST. The inhibitory effect of L-NAME on CLO -dependent prolongation of TST was reversed by L-arginine. These results suggest that NO-dependent mechanisms are involved in the sedative effect of CLO. In addition, this effect seems to be specific for the sedative action of α2-adrenoceptors agonists. The possible involvement of an opioid and NO-GMPc pathway link in the antinociceptive effect of CLO was also evaluated. The antinociceptive effect induced by systemic administration of CLO and rilmenidine (RIL) was evaluated using the mice writhing tests and TFL. CLO (3120 g/kg) and RIL induces a dose-dependent antinociceptive effect in the writhing tests and TFL. The antinociceptive effect of CLO was significantly reduced by NO-synthase and guanylyl cyclase inhibition. RIL effect was also reduced by 7-NI.The antinociceptive effect of morphine, but not CLO, was inhibited by naloxone. Our current results suggest that the antinociceptive effect of systemic clonidine does not involve the opioid receptor and is modulated by the NO-cGMP pathway.

INTRODUÇÃO: Tramadol é conhecido como um fármaco analgésico de ação central utilizado no tratamento de dores de intensidades moderada a forte. Efeito analgésico local já foi demonstrado. É, em parte, semelhante ao efeito anestésico local, mas outros mecanismos permanecem desconhecidos. O papel de receptores opioides periféricos na analgesia do tramadol na dor pós-operatória não é conhecido. Neste estudo, foi estudado o papel dos receptores opioides no efeito analgésico local do tramadol em modelo de dor por incisão plantar. MÉTODOS: Ratos machos jovens foram submetidos à incisão plantar e no primeiro dia pós-incisão foram divididos em quatro grupos: Grupo IP I-SF/SF - 50 uL de solução de NaCl 0,9% foram injetados na região plantar da pata posterior homolateral à incisão e, 15 minutos depois, novamente injetada a mesma quantidade de solução; Grupo IP II-SF/T_homo - 50 uL de NaCl 0,9% foram injetados na região plantar da pata homolateral e, 15 minutos depois, injetados 50 µL solução contendo 5 mg tramadol; Grupo IP III-SF/T_contra -50 uL de NaCl 0,9% foram injetados na região plantar da pata contralateral e, 15 minutos depois, 50 uL de solução contendo 5 mg de tramadol; Grupo IP IV-Nal/T_homo - 50 uL de solução contendo 200 ug de naloxona foram injetados na pata homolateral e, 15 minutos depois, 50 uL de solução contendo 5mg de tramadol foi injetada. Antes de receberem as injeções, os limiares de retirada da pata por estímulo mecânico produzido por analgesímetro eletrônico de von Frey foram medidos, e, depois da administração dos fármacos, os limiares de retirada foram avaliados nos tempos 15, 30, 45 e 60 minutos após a administração dos fármacos. O mesmo procedimento foi utilizado no segundo dia pós-incisão. As expressões proteicas dos receptores opioide ? (DOR) e µ (MOR) foram avaliadas usando técnica de immunoblotting de gânglios de raízes dorsais homolaterais (L3, L4, L5 e L6) de grupos de animais sem incisão e após 1, 2, 3 e 7 dias de animais submetidos à incisão plantar. RESULTADOS: A incisão plantar gerou marcada hiperalgesia mecânica que foi revertida por tramadol intraplantar nos dois dias. O tramadol intraplantar em pata contralateral não antagonizou a hiperalgesia mecânica, a naloxona antagonizou parcialmente o efeito analgésico do tramadol no primeiro dia pós-incisão, e antagonizou completamente no segundo dia pós-incisão. A expressão proteica de DOR aumentou no 2º, 3º e 7º dias pós-incisão, a expressão de MOR não se modificou. CONCLUSÕES: O tramadol apresentou efeito analgésico local após estímulo mecânico e esse efeito foi antagonizado por naloxona no segundo dia pós-incisão. A expressão de DOR aumentou após a incisão plantar / BACKGROUND: Tramadol is known as a central acting analgesic drugused for the treatment of moderate to severe pain. Local analgesic effect was already demonstrated. It is in part due to local anesthetic-like effect, but other mechanisms remain unclear. The role of peripheral opioid receptors in the local analgesic effect in postoperative pain is not known. In this study, we examined the role of peripheral opioid receptors in the local analgesic effect of tramadol in the plantar incision pain model. METHODS: Young male Wistar rats were submitted to plantar incision and in the first postoperative day (POD1) were divided into four groups:IP I-SF/SF,50 uL of 0.9% NaCl solution were injected in the plantar aspect of the homolateral hindpaw and again after 15 minutes; IP II-SF/T_homo, 50 uL of 0.9% NaCl solution were injected in the plantar aspect of the homolateral hindpaw and, 15 minutes later, 50 µL of solution containing 5 mg tramadol were injected in the same hindpaw; IP III-SF/T_contra, 50 uL of 0.9% NaCl were injected in the plantar aspect of the contralateral hindpaw and, 15 minutes later, 50 uL of solution containing 5 mg tramadol were injected in the same hindpaw; IP IVNal/T_homo, 50 uL of naloxone (200 ug) solution were injected in the homolateral hindpaw and 15 minutes later 50 µL of solution containing 5 mg tramadol were injected. Before receiving the assigned drugs, baseline withdrawal thresholds for mechanical hyperalgesia using electronic von Frey were measured, then, after receiving the assigned drugs, withdrawal thresholds were measured at 15, 30, 45 and 60 min after drug injection. The same procedure was repeated in POD2. u opioid receptor (MOR) and opioid receptor (DOR) protein expressions were evaluated using immunoblotting after removal of ipsilateral dorsal root ganglia (L3, L4, L5 and L6) in groups of rats non submitted to plantar incision and 1, 2, 3 and 7 days after incision. RESULTS: Plantar incision led to marked mechanical hyperalgesia that was reversed with intraplantar tramadol in both days. Contralateral tramadol did not affect mechanical hyperalgesia and naloxone antagonized partially intraplantar tramadol in POD1, and antagonized completely in POD2. DOR expression in DRGs increased in POD2, POD3 and POD7, MOR expression did not change. CONCLUSIONS: Tramadol presented local analgesic effect after mechanical stimuli and this effect was antagonized by naloxone in the second post incision day. DOR increased expression after plantar incision

No description available.