Abstract
In a double-blind cross-over study on 22 healthy subjects the analgesic efficacies of the antipyretic analgesic drugs ibuprofen, dipyrone and paracetamol were tested against placebo using a model of experimentally induced pain. To this purpose interdigital webs were pinched repeatedly for 2 min periods. The painfulness of these stimuli was assessed by the subjects on an electronically controlled visual analogue scale at 10 sec intervals. In addition to the subjective pain rating the stimulus induced reflex diminution of the blood flow in the stimulated hand was measured with photoplethysmography and laser Doppler flow analysis. The flare response around the stimulated area was assessed with infrared thermography. In this assay system ibuprofen and dipyrone, but not paracetamol, showed statistically significant analgesic effects by preventing hyperalgesia which is normally induced by the repeated stimulation of a skin site. This hypoalgesic effect was not related to the subjective impression of the subjects of the analgesic potency of the respective drug. Sympathetic reflex vasoconstriction was not quantitatively related to the drug induced hypoalgesia. Ibuprofen and, to a minor extent, the other antipyretic analgesic drugs also diminished the stimulus induced flare reaction around the stimulated skin sites.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
H. K. Beecher, Measurement of subjective responses.Quantitative effects of drugs. Oxford University Press, New York (1959).
R. Melzack and K. L. Casey,Sensory, motivational and central control determinants of pain. InThe skin senses (Eds. D. Kenshalo, Thomas, Springfield Ill.), pp. 423–443, 1968.
H. O. Handwerker and P. W. Reeh,Pain and Inflammation. InProceedings of the VIth World Congress on Pain (Pain Research and Clinical Management, Vol. 5), (Eds. M. Bond, J. E. Charlton & C. Woolf), Elsevier, North Holland, 1991.
F. Anton, H. O. Handwerker, A. Kreh, P. W. Reeh, E. Walter and E. Weber,Influence of acetylsalicylic and salicylic plasma levels on psychophysical measures of long standing natural pain stimuli. InAdvances in Pain Research and Therapy (Eds. H. L. Fields, R. Dubner & F. Cervero), Raven Press, New York, 781–789 (1985).
C. Forster, F. Anton, P. W. Reeh, E. Weber and H. O. Handwerker,Measurement of the analgesic effects of aspirin with a new experimental algesimetric procedure. Pain32, 215–222 (1988).
H. O. Handwerker,Der Wirkungsnachweis von Ibuprofen und anderen nichtsteroidalen Antirheumatika in der experimentellen Algesimetrie. Ztschr. Rheumatologie,Suppl. 1, 15–18 (1991).
H. O. Handwerker, A. Beck, C. Forster, Th. Gall and W. Magerl,Analgesic effects of dipyrone as compared to placebo. InNew Pharmacological and epidemiological data in analgesics research (Ed. K. Brune), Birkhäuser Verlag, Basel, Boston, Berlin 19–28 (1990).
I. Z. Katz, L. Granit, D. E. Drayer and M. Levy,Simultaneous determination of dipyrone metabolites in plasma by high-performance liquid chromatography. J. Chromatogr.305, 477–484 (1984).
G. Geisslinger, K. Dietzel, D. Loew, O. Schuster, G. Rau, G. Lachmann and K. Brune,High-performance liquid chromatographic determination of ibuprofen, its metabolites and enantiomers in biological fluids. J. Chromatogr.491, 139–149 (1989).
S. Mineshita, R. Eggers, N. R. Kitteringham and E. E. Ohnhaus,Determination of phenacetin and its major metabolites in human plasma and urine by high-performance liquid chromatography. J. Chromatogr.380, 407–413 (1986).
D. Jung and N. K. Zafar,Micro high-performance liquid chromatographic assay of acetaminophen and its major metabolites in plasma and urine. J. Chromatogr.339, 198–202 (1985).
H. Adriaensen, J. Gybels, H. O. Handwerker and J. Van Hees,Nociceptor discharges and sensations during prolonged noxious mechanical stimulation—a paradox. Human Neurobiol.3, 53–58 (1984).
W. Magerl, G. Geldner and H. O. Handwerker,Pain and vascular reflexes in man elicited by prolonged noxious mechano-stimulation. Pain43, 219–225 (1990).
W. Magerl, R. A. Westerman, B. Möhner and H. O. Handwerker,Properties and transdermal histamine iontophoresis-differential effects of season, gender, and body region. Journal Invest. Dermatol.94, 347–352 (1990).
G. Geisslinger, K. Dietzel, H. Bezler, B. Nürnberg and K. Brune,Therapeutically relevant differences in the pharmacokinetical and pharmaceutical behaviour of ibuprofen lysinate as compared to ibuprofen acid. Int. J. Clin. Pharmacol. Ther. Tox.27, 7, 324–328 (1989).
S. A. Cooper,The relative efficacy of ibuprofen in dental pain. Compend. Contin. Educ. Cent.7, 578–597 (1987).
M. S. Kramer and L. E. Naimark,Risks and benefits of paracetamol antipyresis in young children with fever of presumed viral origin. The Lancet337, 591–594 (1991).
H.-J. Schroth, H. Garth, St. Rupp and A. Steinsträßer,Wirkung von Metamizol auf die Harnwegs-Motilität. Fortschritte der Medizin18, 378–382 (1986).
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Forster, C., Magerl, W., Beck, A. et al. Differential effects of dipyrone, ibuprofen, and paracetamol on experimentally induced pain in man. Agents and Actions 35, 112–121 (1992). https://doi.org/10.1007/BF01990960
Received:
Accepted:
Issue date:
DOI: https://doi.org/10.1007/BF01990960
