Effect of 5-HT3 serotonergic receptor blockade on the evaluation of
thermal, mechanical pain thresholds and conditioned pain modulation in
humans.
Abstract
One form known as pain modulation is the phenomenon of inhibiting pain
using a prior pain stimulus. The term CPM (conditioned pain modulation)
is used to describe this phenomenon in humans. Serotonin pathways work
as both anti- and pro-nociceptive pathways. Ondansetron is a 5HT3
receptor antagonist routinely used to prevent postoperative nausea and
vomiting. Therefore, this study’s objective was to evaluate
ondansetron’s effect on mechanical and thermal pain thresholds, as well
as CPM in humans. 17 volunteers, who were randomly selected and
double-blinded, participated in the research. They received an
intravenous solution containing 1 - NaCl at 0.9%, in a volume of 20 mL;
2 - NaCl at 0.9% and 8 mg ondansetron in a volume of 20 mL. Using the
quantitative sensory test (QST), we obtained the thresholds for
detecting warm and cold; pain thresholds to hot and cold; the pressure
pain threshold. CPM was evaluated using the parallel paradigm in which
two identical nociceptive test stimuli were induced before and
simultaneous to a conditioned nociceptive stimulus. Thirty minutes after
the intervention, we redid the tests. We repeated the tests one week
later but using the different solution so that each participant was
their own control (crossover). We used the Wilcoxon test to compare the
variables. Ondansetron, intravenously, improved CPM (p<0.05)
and influenced thermal detection thresholds (heat and cold p <
0.05). There is evidence that the results related to the antagonism of
the 5HT-3 receptor by ondansetron, occur through inhibition of
facilitating descending pathways, improving the CPM.