Nociceptive flexion reflex and pain rating responses during endogenous opiate blockade with naltrexone in healthy young adults

Abstract

The effect of opioid blockade on nociceptive flexion reflex (NFR) activity and subjective pain ratings was examined in 151 healthy young men and women. Using a within-subjects design, NFR threshold was assessed on 2 days after administration of either placebo or a 50mg dose of naltrexone. Electrocutaneous pain threshold and tolerance levels were measured after NFR threshold assessment on each day. Results indicated that administration of naltrexone was consistently associated with hypoalgesic responding. Specifically, participants exhibited lower levels of NFR activity and reported lower pain ratings for electrocutaneous stimulation delivered at pain threshold and tolerance levels following administration of naltrexone as compared to placebo. These findings indicate that opiate blockade using the current standard dose may elicit hypoalgesia. A potential moderating effect of dose of opiate-blockade medication and level of endogenous opioid activation should be carefully examined in future research.

Figure 1

Rectified electromyogram (EMG) recorded during electrocutaneous stimulation at pain threshold (A) and tolerance (B) following placebo and naltrexone administration. Nociception flexion reflex (NFR) activity is defined by the 90 to 150 ms post-stimulation interval.