Comparison of the effects of ureteral calculosis and occlusion on muscular sensitivity to painful stimulation in rats

Construction of a novel rabbit model of ureteral calculi implanted with flowable resin

BACKGROUND

The purpose of this study was to characterize the pathophysiological changes of hydronephrosis caused by ureteral calculi obstruction in a new rabbit ureteral calculi model by implanting flowable resin.

METHODS

Forty New Zealand rabbits were randomly divided into two groups: the calculi group and the sham control group. In the calculi group (n = 20), rabbits were operated at left lower abdomen and the left ureter was exposed. Then flowable resin (flowable restorative dental materials) was injected into the left ureter using a 0.45 mm diameter intravenous infusion needle. Then light-cured for 40 s by means of a dental curing light to form calculi. In the sham control group, normal saline was injected into the ureter. Rabbits underwent X-ray and routine blood and urine tests preoperatively, as well as X-ray, CT, dissection, HE staining and routine blood and urine tests on 1, 3, 5 and 7 days postoperatively. Stone formation was assessed by X-ray and unenhanced CT scan after surgery. The pathophysiological changes were evaluated through dissection, HE staining and routine blood and urine tests.

RESULTS

Ureteral calculi models were successfully constructed in 17 rabbits. In calculi group, high-density shadows were observed in the left lower abdomen on postoperative day 1st, 3rd, 5th and 7th by X-ray and CT scan. Dissection found obstruction formation of the left ureters, dilatation of the renal pelvis and upper ureter during 7 days after surgery. The renal long-diameters of the left ureters increased only on the 1st postoperative day. HE staining found ureteral and kidney damage after surgery. In calculi group and sham group,the serum creatinine, urea nitrogen, white blood cells and urine red blood cells were raised at day 1 after surgery. However, the indicators returned to normal at day 3, 5, and 7.

CONCLUSIONS

This is a stable, less complicated operation and cost-effective ureteral calculi model by implanting flowable resin. And this novel model may allow us to further understand the pathophysiology changes caused by ureteral calculi obstruction.

Visceral pain

Modeling visceral pain requires an appreciation of the underlying neurobiology of visceral sensation, including characteristics of visceral pain that distinguish it from pain arising from other tissues, the unique sensory innervation of visceral organs, the functional basis of visceral pain, and the concept of viscero-somatic and viscero-visceral convergence. Further, stimuli that are noxious when applied to the viscera are different than stimuli noxious to skin, muscle, and joints, thus informing model development and assessment. Visceral pain remains an important and understudied area of pain research and basic science knowledge and mechanisms acquired using animal models can translate into approaches that can be applied to the study and development of future therapeutics.

Painful dilemmas: the ethics of animal-based pain research

While it has the potential to deliver important human benefits, animal-based pain research raises ethical questions, because it involves inducing pain in sentient beings. Ethical decision-making, connected with this variety of research, requires informed harm-benefit analysis, and the aim of this paper is to provide information for such an analysis. We present an overview of the different models and their consequences for animal welfare, showing that, of the many animal models available, most have a considerable welfare impact on the animal. While the usual approach to pain control through administration of analgesic substances is usually unsuitable in pain research, refinement remains an option, both within the experimental protocol and in general husbandry and handling. Drawing on the overview, we develop a discussion of the ethical acceptability of animal-based pain research against the background of the kinds of harm done to the animals involved, the potential for refinement, and the expected benefits of the research.

Effects of tramadol on behavioural indicators of colic pain in a rat model of ureteral calculosis

This study investigated the effect of prolonged administration of tramadol vs. placebo on behavioural indicators of ureteral pain and referred lumbar muscle hyperalgesia in a rat model of artificial ureteral calculosis. Four groups of 10 rats each (female, Sprague-Dawley) were treated twice a day, for 4 days, with i.p. injections of tramadol 1.25 mg/kg, 2.5 mg/kg, 5 mg/kg or saline, respectively. The first injection was delivered 45 min before laparotomy (under pentobarbital anaesthesia) for formation of the stone in the upper left ureter via injection of dental cement. All rats were video-taped 24 h non-stop from the immediate postoperative period until the 4th day for recording of behavioural ureteral crises indicative of colic pain. Lumbar muscle sensitivity was tested daily over the same period by verifying presence or absence of vocalization upon pinching of the parietal layers at L1 level, bilaterally, at a constant predefined pressure value with calibrated forceps. Tramadol significantly reduced number and global duration (ANOVA, P < 0.008 and P < 0.004) of ureteral crises with respect to saline and the effect was dose-dependent (linear regression analysis between doses and parameters of crises, P < 0.003 and P < 0.002). The drug also significantly reduced the incidence of referred muscle hyperalgesia (ANOVA, P < 0.0001). It is concluded that tramadol is highly effective in controlling pain phenomena from urinary stones and can represent a valid therapeutic approach in patients with urinary colics.

Influence of endometriosis on pain behaviors and muscle hyperalgesia induced by a ureteral calculosis in female rats

Endometriosis and urinary calculosis can co-occur. Clinical studies have shown that both painful and non-painful endometriosis in women are associated with enhanced pain and referred muscle hyperalgesia from urinary calculosis, but the mechanisms underlying this phenomenon are still poorly understood. The aim of this study was to develop an animal model adequate to explore this viscero-visceral interaction in standardized conditions. Using a model of endometriosis previously developed to study reduced fertility and vaginal hyperalgesia, endometriosis (endo) or sham-endometriosis (sham-endo) was induced in rats by autotransplantation of small pieces of uterus (or, for sham-endo, fat) on cascade mesenteric arteries, ovary, and abdominal wall. After the endometrial, but not the fat autografts had produced fluid-filled cysts (3 weeks), urinary calculosis was induced by implanting an artificial stone into one ureter. Pain behaviors were monitored by continuous 24-h videotape recordings before and after stone implantation. Referred muscle hyperalgesia was assessed by measuring vocalization thresholds to electrical stimulation of the oblique musculature (L1 dermatome). The data were compared with previously reported data from rats that had received only the stone. Neither endo nor sham-endo alone induced pain behaviors. Following stone implantation, in endo rats compared to sham-endo and stone-only rats, pain behaviors specifically associated with urinary calculosis were significantly increased and new pain behaviors specifically associated with uterine pathology became evident. Muscle hyperalgesia was also significantly increased. To explore the relationship between the amount of endometriosis and that of ureteral pain behavior, two separate groups of endo rats were treated with either a standard non-steroidal anti-inflammatory drugs (ketoprofen) or placebo from the 12th to the 18th day after endometriosis induction. The stone was implanted on the 21st day. Ketoprofen treatment compared to placebo significantly reduced the size of the cysts and both ureteral and uterine pain behaviors post-stone implantation. The size of the cysts showed a significant linear correlation with the post-stone ureteral pain behaviors. In conclusion, endo increased pain crises and muscle hyperalgesia typically induced by a ureteral calculosis, and the ureteral calculosis revealed additional pain behaviors typically induced by uterine pathophysiology; and this enhancement was a function of the degree of endometriosis. This result closely reproduces the condition observed in humans and could be due to a phenomenon of 'viscero-visceral' hyperalgesia, in which increased input from the cyst implantation sites to common spinal cord segments (T10-L1) facilitates the central effect of input from the urinary tract.

[Acute pain measurement in animals. Part 1]

OBJECTIVE

To describe tests of nociception which appear in the "pre-clinical" literature.

DATA SOURCES

References obtained by computerized bibliographic research (Medline) and the authors' personal data.

DATA SYNTHESIS

Ethical problems arising from the study of the pain in awake animals, problems arising from the choice of stimulus and stimulus parameters and the quantification of responses are presented. Pain in animals can be estimated only by examining their reactions, but at the same time, the existence of a reaction does not necessarily mean that there is a concomitant sensation. A description of the signs of pain in mammals is proposed. A noxious stimulus can be defined by its physical nature, its site of application and what has previously happened to the tissues at this site. Electrical stimulation short-circuits the process of transduction at free nerve endings and is not specific; however it has the advantage that it can be applied suddenly and briefly and thus results in synchronised signals in the relevant primary afferent fibres which can be differentiated into A delta and C fibres. Heat selectively stimulates thermoreceptors and nociceptors, but the low calorific power of conventional stimulators restricts their usefulness. Radiant sources have the disadvantage of emitting waves in the visible and the adjacent infrared spectra, for which the skin is a poor absorber and good reflector. Thermodes have the disadvantage of activating mechanoreceptors and thermoreceptors simultaneously; furthermore, their capacity for transferring heat depends on the quality of contact with skin and thus on the pressure with which they are applied. These problems can be overcome by using CO2 lasers but even today, the cost of these is a major disadvantage. Chemical stimuli differ from those mentioned above by the progressive onset of their effectiveness, their duration of action and the fact that they are of an inescapable nature. Experimental models employing chemical stimuli are undoubtedly the most similar to acute clinical pain. A wide spectrum of reactions are observed in nociceptive tests, but in almost every case they involve motor responses. After defining the ideal characteristics of a nociceptive test, tests based on the use of short duration and longer duration stimuli are presented. In tests of phasic pain, reactions are evoked by thermal (tail-flick test, hot-plate test), mechanical or electrical (flinch-jump test, vocalisation test) stimuli. Tests of tonic pain employ injections of algogenic agents intradermally (formalin test) or intraperitoneally (writhing test) or even the dilation of hollow organs. All these tests will be critically appraised in a subsequent paper [1].

CONCLUSION

The tail-flick and hot-plate tests are the most used, but there is an increasing recourse to the formalin test and tests involving foot withdrawal after mechanical stimulation.

Pre-emptive analgesia in rats with artificial ureteric calculosis. Effects on visceral pain behavior in the post-operative period

'Pre-emptive' analgesia is a controversial issue in both the clinical and experimental literature on pain. This paper investigates the effect of chronic (4 days) administration of morphine or ketoprofen initiated pre- or post-operatively on behavioral indicators of visceral pain and referred hyperalgesia in an animal model of artificial ureteric calculosis. In the morphine experiment, female Sprague-Dawley rats were treated i.p. with saline or morphine sulphate (2.5 or 5 mg/kg/day) starting either 45 min before or 45 min after surgery (pentobarbital anesthesia) for stone implantation in the left ureter, until the 4th day after intervention. Behavioral crises of ureteric pain were recorded (video-tape) in all rats over 4 days post-operatively. Number, duration and complexity of crises of stone-rats were significantly and dose-dependently reduced by administration of morphine with respect to saline in an identical manner for the pre- and post-operative treatment. In the ketoprofen experiment, rats were given saline or ketoprofen (15 mg/kg/day, in 3 i.p. injections per day) starting either pre- or post-operatively with the same paradigm as for the morphine study. Vocalization thresholds to electrical stimulation of the left oblique musculature were measured daily for 3 days pre- and 4 days post-operatively. Muscle hyperalgesia (post-operative decrease in threshold with respect to pre-stone implantation) was significantly reduced in extent and duration in ketoprofen with respect to saline-injected animals but no difference was found between the pre- and post-operative treatment. It is concluded that pre-emptive administration of morphine or ketoprofen has no advantage in reducing behavioral indicators of visceral pain and referred hyperalgesia in this animal model.

Models of Visceral Nociception

Pains arising from the viscera constitute a large portion of clinically treated pains. They are characterized by poor localization; immobility with tonic increases in muscle tone; and vigorous but nonspecific changes in autonomic function, such as changes in respiration, heart rate, and blood pressure. Tissue-damaging stimuli do not reliably produce visceral pain, so the study of visceral nociception in nonhuman animals requires identification of appropriate stimuli and responses. This article defines "noxious" visceral stimuli as those that produce pain in humans, result in aversive behaviors in animals, and evoke responses that are inhibited by manipulations known to be analgesic in humans. To be valid, the measured responses must be reliable, inhibited by known analgesics, and not inhibited by nonanalgesics. Using these criteria as measures of validity, the author examined several visceral pain models. The writhing test (application of intraperitoneal irritants) failed to meet these criteria; however, responses to small bowel distension, colonic-rectal distension, artificial ureteral calculosis, urinary tract distension, and the intravesical application of irritants met most, if not all, of the criteria. Other models, such as responses to biliary system distension, to reproductive organ stimulation, to the focal application of algesic agents onto various viscera, and to ischemic stimuli, met some of these criteria. This information should assist readers in decisions related to the use of visceral pain models.

Cyclophosphamide cystitis in mice: behavioural characterisation and correlation with bladder inflammation

The generation of transgenic 'knock-out' mice which lack genes relevant to pain is becoming increasing common. However, only one visceral pain model, the writhing test, is available in mice. The aim of this study was to adapt cyclophosphamide cystitis, a model of inflammatory visceral pain described in rats, for use in mice, and to characterise its behavioural effects. The toxic metabolites of systemically-administered cyclophosphamide are excreted in the urine, and induce bladder inflammation. We compared the effects of cyclophosphamide (100 and 300 mg/kg i.p., 4 h survival period) and vehicle (saline) in male mice on spontaneous behaviour (4 h continuous video-tape, and a 5-min Open Field test after 4 h). Involvement of the urinary bladder and other abdominal tissues was assessed by macroscopic examination and measurement of Evan's Blue plasma extravasation. Cyclophosphamide (300 mg/kg) produced significant changes in behaviour, including 22 +/- 6 min of 'crises' of visceral pain-related behaviour and a 53% reduction in activity, and also induced haemorrhage and substantial plasma extravasation in the bladder, but no change in other abdominal tissues. We conclude that cyclophosphamide cystitis has many advantages as a model of sub-acute, inflammatory visceral pain in mice. It does not require surgery or intubation, and we have found it to produce consistent, reproducible and quantifiable behavioural changes, which are significantly correlated with the degree of bladder inflammation in the absence of inflammation of other abdominal tissues. Copyright 1999 European Federation of Chapters of the International Association for the Study of Pain.

Spinal mechanisms underlying persistent pain and referred hyperalgesia in rats with an experimental ureteric stone

Spinal neurons processing information from the ureter have been characterized in rats 1-4 days after the implantation of an experimental ureteric stone and compared with those of normal rats. The effects of a conditioning noxious stimulation of the ureter in the presence of the hyperalgesia evoked by the calculosis also were examined. Extracellular recordings were performed at the T12-L1 segments of the spinal cord. In rats with calculosis, more neurons expressed a ureter input (53 vs. 42% in normal rats); such cells being more likely to show background activity, at a higher rate than normals (6.6 +/- 1.2 vs. 3.2 +/- 0.9 spikes/s; mean +/- SE) and increasing with the continuing presence of the stone. The threshold pressure for a ureteric response was higher than in normal rats (79 +/- 5 vs. 54 +/- 4 mmHg) but the neurons failed to encode increasing intensities of stimulation. Thirty-five percent of the neurons with exclusively innocuous somatic receptive fields had a ureter input in rats with calculosis, whereas none were seen in normal rats. A noxious ureteric distention applied to neurons with ureter input evoked a complex mixture of increases and decreases in somatic receptive field size and/or somatic input properties markedly different from the generalized increases in excitability seen when such a stimulus was applied to normal animals. We conclude that the presence of a ureteric stone evokes excitability changes of spinal neurons (enhanced background activity, greater number of ureter-driven cells, decreased threshold of convergent somatic receptive fields), which likely account for the referred hyperalgesia seen in rats with calculosis. However, further noxious visceral input occurring in the presence of persistent hyperalgesia produces selective changes that cannot be explained by a generalized excitability increase and suggest that the mechanisms underlying maintenance of hyperalgesia include alteration of both central inhibitory and excitatory systems.

Chemosensitivity of nociceptive, mechanosensitive afferent nerve fibres in the guinea-pig ureter

The mechanosensitivity and chemosensitivity of afferent fibres were investigated in an in vitro preparation of the guinea-pig ureter. Electrophysiological recordings were obtained from 5 U-1 (low mechanical threshold, contraction-sensitive) and 74 U-2 units (high threshold). U-2 units had significant higher levels of spontaneous activity, lower conduction velocities, higher mechanical thresholds (U-1: 7 mmHg; U-2: 39 mmHg), less pronounced phasic responses and longer latencies in the response to distensions than the U-1 units. For chemical stimulation, guinea-pig urine (> 800 mosmol/L), bradykinin and capsaicin were applied intraluminally. The responses of U-1 units mainly corresponded to the contractions induced by the chemical stimulation. The vast majority of the U-2 units were excited by urine, bradykinin (threshold: 0.1-1 microM) and capsaicin (threshold: 0.03-0.3 microM). The responses to urine could be mimicked by high concentrations of potassium ions (> 200 mM), but not by an equiosmolar solution of NaCl, urea and mannitol. Chemical stimulation could also result in a transient sensitization of the U-2 units to mechanical stimuli. In the anaesthetized guinea-pig, pseudo-affective responses could be evoked by ureteric distension (threshold: 30-60 mmHg) and serosal application of capsaicin. Intraluminal application of urine in vivo did not evoke any reactions, suggesting that the responses of the U-2 units to urine might be due to an impaired barrier function of the urothelium in vitro. The data are in agreement with the hypothesis that U-2 units are visceral polymodal nociceptors. Since the U-1 units were also able to encode at least noxious mechanical stimuli, their involvement in visceral nociception cannot be excluded.

Changes in visceral pain reactivity as a function of estrous cycle in female rats with artificial ureteral calculosis

This study examined estrous differences in the characteristics of behavioral crises of visceral pain in female rats video-taped throughout a 4-day period after implantation of an artificial stone in one ureter. All animals continued to have a regular cycle after ureteral surgery. In the recording period, the percentage of time spent in crises was significantly higher during metestrus/diestrus (M/D) than during proestrus/estrus (P/E) (P < 0.001, chi2-test). Mean duration and complexity of crises were slightly higher in M/D than in P/E, but the difference was not significant. The results in this animal model show an enhancement of ureteral pain sensitivity in M/D, a finding in line with the clinical observation, in fertile women with urinary calculosis, of a greater incidence of colics in the perimenstrual period (equivalent to M/D in rats).

Effects of metamizol on nociceptive responses to stimulation of the ureter and on ureter motility in anaesthetised rats

In this study, we have examined the effects of metamizol (dipyrone), a non-opioid analgesic which is effective in relieving renal colic pain, on nociceptive responses evoked by stimulation of the ureter, on pyeloureteral motility and on intraureter pressure after ureter obstruction in anaesthetised rats. Metamizol (5- 50 mg/kg i.v.) dose-dependently inhibited reflex pressor responses evoked by distensions of the ureter to pressures of 30, 55 and 75 mmHg for 30 s (ID50 = 8 +/- 1 mg/kg). Metamizol also dose-dependently reduced intraureter pressure during total ureter occlusion (25 mg/kg produced a reduction of 25% in 10 min). However, metamizol at doses up to 50 mg/kg had no effect on pyleoureteric motility (contraction amplitude, rate or intraureter pressure) under normal pressure conditions. We conclude that metamizol has a direct antinociceptive action on pain of ureteric origin, and spasmolytic effects after ureter obstruction (but not under normal conditions) which may also contribute to pain relief.

Increased c-fos expression in spinal neurons induced by electrical stimulation of the ureter in the rat

The spinal processing of afferent input from the ureter was examined using an immunocytochemical technique to detect the expression of c-fos, an immediate early gene. Proximal and distal sites in one ureter were electrically stimulated separately or together at intensities that elicited a pseudo-affective response (an increase in arterial pressure). Very few Fos+ cells (range: 0.6-6.6 cells/half section were present in the L(1)-L(2), L(5)-S(2) spinal segments in sham operated control animals; however, following stimulation of the ureter, a significant increase in the numbers of Fos+ cells was detected at spinal levels L(1)-L(2) (mean 24.5-33.1 cells/half section) and L(6)-S(1) (mean 17.4-33.0 cells/half section). In L(6)-S(1), the numbers of Fos+ cells were significantly greater ipsilateral (mean 25.2 cells/half section) vs. contralateral (12.3 cells/half section) to stimulation; whereas in L(1)-L(2), the numbers were similar on both sides of the spinal cord. In L(1)-L(2), a greater percentage of Fos+ cells was present in superficial medial (MDH, 49.7%) and lateral dorsal horn (LDH, 40.8%); whereas in L(6)-S(1), the cells were more numerous in sacral parasympathetic nucleus (SPN, 38.7%) and LDH (25.6%*) regions. This distribution of Fos+ cells varies in a number of respects from that noted in previous experiments after chemical irritation of the urinary bladder and urethra which activated neurons only in L(6)-S(1) and primarily in the DCM and MDH. The results indicate that nociceptive afferent inputs from different areas of the urinary tract are processed in different regions of the spinal cord.

Changes in activity of spinal cells with muscular input in rats with referred muscular hyperalgesia from ureteral calculosis

In rats with hyperalgesia of the obliquus externus muscle (OE) from artificial calculosis of the ipsilateral upper ureter, changes in cell activity were studied in the ipsilateral spinal cord (T11-T12) versus control animals. In cases of hyperalgesia of high degree, in the dorsal horn (0-900 microns) the following were found: significantly higher percentages of cells driven by OE stimulation (P < 0.03) and of spontaneously active cells with OE input (P < 0.02); significantly higher frequency of background discharge of cells with OE input (P < 0.002); among cells driven by OE stimulation, significantly higher percentages of neurons with exclusively deep input (P < 0.0006) and of neurons with low mechanical threshold of activation (P < 0.03). In the intermediate region of the cord (900-1600 microns), a significantly higher percentage was found of spontaneously active cells with OE input (P < 0.009) while in the ventral horn (1600-2300 microns) no changes were detected. The results indicate that referred muscle hyperalgesia of high degree is accompanied by a state of central sensitization probably triggered by the abnormal afferent input from the visceral focus.

Pressor responses to distension of the ureter in anaesthetised rats: characterisation of a model of acute visceral pain

We have characterised pressor responses to stimulation of the ureter in anaesthetised rats (n = 20) as a model of acute visceral pain. The left ureter was cannulated close to the bladder and graded stimuli applied (5-90 mmHg, 30 s). The threshold was approximately 25 mmHg. Suprathreshold pressures evoked responses proportional to the stimulus intensity, which were little altered when stimulation of the kidney was prevented by ligation of the ureteric-pelvic junction. The stimulus response curve was dose-dependently attenuated by morphine (1-3 mg kg-1 i.v.), in a naloxone reversible manner. The characteristics of the responses observed correlate well with pain sensation in man and with the properties of ureteric primary afferent neurones in animals.

Artificial ureteral calculosis in rats: behavioural characterization of visceral pain episodes and their relationship with referred lumbar muscle hyperalgesia

In a rat model of artificial ureteral calculosis, the aim of the study was to characterize the behavioural manifestations of direct visceral pain and to evaluate the relationship between number, duration and complexity of the visceral episodes and the extent of referred lumbar muscular hyperalgesia. As evidenced by non-stop video-tape recordings over 4-14 days, almost 98% of stone-implanted rats showed episodes similar to the writhing behaviour characteristic of noxious visceral stimulation in animals. From one rat to another, these episodes varied from very few (1-3) to a very high number (+/- 60), lasted a few minutes to over 45 min and were of variable complexity, as evaluated via an arbitrary scale on the basis of the combination of movements. Their number and duration decreased significantly, in a linear fashion, as time passed after the operation, so that they were mostly concentrated during the first 3 days. Number, duration and complexity of episodes were reduced by chronic treatment with morphine in a dose-dependent fashion. Stone-implanted rats displaying visceral episodes also showed hyperalgesia of the ipsilateral oblique musculature, as evidenced by a decrease in the vocalization threshold to electrical muscle stimulation, which was maximum on the first 3-4 days after implantation but lasted up to 10 days. The visceral episodes and the muscle hyperalgesia showed a strict relationship of interdependence: a significant, direct linear correlation was found between number and duration of episodes and tendency to also develop a contralateral muscle hyperalgesia. By applying the results of the study to the interpretation of human pathology, referred lumbar muscle hyperalgesia from ureteral calculosis would appear to be a strict function of the colic pain experienced.

Effects of spasmolytic and/or non-steroidal antiinflammatory drugs on muscle hyperalgesia of ureteral origin in rats

Rats with artificial calculosis of one ureter develop hyperalgesia in the ipsilateral oblique musculature as evidenced by decreased vocalization threshold to electrical muscle stimulation lasting over a week. The aim of the study was to evaluate the effect on this hyperalgesia of spasmolytic anticholinergic and/or non-steroidal antiinflammatory drugs, common therapies for colic pain in humans. Rats implanted with a unilateral ureteral stone were treated for 10 days with: (1) saline; (2) hyoscine-N-butylbromide (15 mg/kg/day i.p.); (3) ketoprofen (15 mg/kg/day); or (4) hyoscine-N-butylbromide + ketoprofen (15 + 15 mg/kg/day). Oblique muscle vocalization thresholds were measured daily for 3 days before and 10 days after operation. Ipsilateral thresholds decreased significantly after stone implantation on: (1) seven days (max. 32%) for saline; (2) one day (max. 20%) for hyoscine-N-butylbromide; (3) one day (max. 18%) for ketoprofen, but did not change significantly for hyoscine-N-butylbromide + ketoprofen. These results indicate a protective effect against muscle hyperalgesia of ureteral origin by spasmolytic and antiinflammatory drugs, maximal when the two treatments are combined.

Inflammation of the colonic wall induced by formalin as a model of acute visceral pain

Acute inflammation of the sigmoid wall was induced by perendoscopic injection of formalin (50 microliters, 5%) under brief anesthesia in rats. The procedure was followed by behavioral patterns that significantly differed from those in animals injected with isotonic saline instead of formalin. Analysis of the formalin-induced behaviors allowed for the calculation of a pain score that evolved in a biphasic manner along the 3 h of test. The score was dose-dependently reduced by morphine (0.5-4 mg/kg), and the analgesic effect of the largest morphine dose was abolished by naloxone (2.4 mg/kg). These results suggest that formalin into the sigmoid colon is a new model of visceral pain, presumably through direct irritation at injection site and/or localized acute inflammation of the intestinal wall.