| Adjuvants/co-analgesics: NMDA-receptor antagonists |
Tissue damage causing persistent nociception, and neuropathic pain states, can activate N-methyl-D-aspartate (NMDA)-receptors in the spinal dorsal horn, producing the phenomenon of ‘wind-up’, with spinal hyperexcitability, allodynia and hyperalgesia (central sensitisation) . NMDA-receptor antagonists can be used to attenuate this central sensitisation with consequent improved analgesia.
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