Chronic administration of minocycline (a tetracycline antibiotic) started 7 days prior to nerve injury prevented neuropathic pain in the animal model – This offers exciting possibilities for preventing post surgical pain conditions.
Eur J Pharmacol. 2008 Oct 18. [Epub ahead of print] Minocycline prevents the development of neuropathic pain, but not acute pain: Possible anti-inflammatory and antioxidant mechanisms. Padi SS, Kulkarni SK.
- Neuropathic pain requires the activation of microglial “helper” cells, especially in the spinal cord.
- Minocycline is a microglial inhibitor
- Given at time of nerve damage, had no effect but started one week prior, “significantly prevented the development of neuropathic pain”
Comment – minocycline has been found to be of some use in treatment of Rheumatoid arthritis. However, rare hepatitis and more recent awareness of rare activation of lupus limits its use. Doxycycline, a similar tetracycline, has similar antiglial properties without the adverse effects. It has anti-arthritic properties see blog. One wonders if it could be a simple matter to pretreat cases prior to surgery to prevent the problems.
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