体性知覚性誘発電位におよぼす薬剤の効果—新鎮痛剤S−9700の使用経験より

CLINICAL EFFECTIVENESS AND INFLUENCES OF THE S-9700 ANALGETICA ON HEADACHES AND SOMATOSENSORY EVOKED POTENTIALS

緒言

　痛みはその性格として，原感覚（original sensation）とそれに続く疼痛反応（reaction to sensation）を有している。このため人間にとつて有意義な生体防禦反応を示してくれる反面，その作用如何によつては最大の苦痛の原因となつている。

　我々臨床家の門を叩く大半の患者が，この痛みを訴えており，普辺的な症状の一つでありながら，痛みが余りにも原始的な感覚の為に，痛みの性格，強度の測定は困難で，このように薬の多く氾濫した今日でも的確な鎮痛を施すことは難かしい。痛みを取り除くことは神の技であるというHippocratesの言葉は現在にもあてはまると思われる。

A newly introduced analgetics, S-9700(d-proxy-phene napsylate) had been investigated from the stand-point of views of clinical assessment and electro-physiological efficacy.

The drug was administered in two groups of subjects and electroencephalograms and somato-sensory evoked potentials were recorded. A group of subjects was composed of healthy adults as a control, and B group was composed of patients complaining of miscellaneous headaches ; types of vascular, muscle contraction, post-lumbar puncture, meningeal, intracranial tumors and post-operative natures.

The results were as follows :

1) No any changes were noticed on the electro-encephalograms, but changes of the late components of somatosensory evoked potential were noticed markedly.

2) Clinical efficacy of the drug on headache was significantly marked in cases of meningeal irritation and post-lumbar puncture headache, however, less effective in the other types of headache.

From the above, the mechanism of drug action was discused with the neural mechanism of pain.