Peppers could offer pain relief

WASHINGTON — Devil’s Revenge. Spontaneous Combustion. Hot sauces have names like that for a reason. Now scientists are testing if the stuff that makes the sauces so savage can tame the pain of surgery.

Doctors are dripping the chemical that gives chili peppers their fire directly into open wounds during knee replacement and a few other highly painful operations.

Don’t try this at home: These experiments use an ultra-purified version of capsaicin to avoid infection, and the volunteers are under anesthesia so they don’t scream at the initial burn.

How could something searing possibly soothe? Bite a hot pepper, and after the burn your tongue goes numb.

The hope is that bathing surgically exposed nerves in a high enough dose will numb them for weeks, so that patients suffer less pain and require fewer narcotic painkillers as they heal.

“We wanted to exploit this numbness,” said Dr. Eske Aasvang, a pain specialist in Denmark who is testing the substance.

Among early results: In a test of 41 men undergoing open hernia repair, capsaicin recipients reported significantly less pain in the first three days after surgery. In a pilot U.S. study of 50 knee replacements, the half treated with capsaicin used less morphine in the 48 hours after surgery and reported less pain for two weeks.

Harvard University researchers are mixing capsaicin with another anesthetic in hopes of developing epidurals that wouldn’t confine women to bed during childbirth, or dental injections that don’t numb the whole mouth. And at the National Institutes of Health, scientists hope early next year to begin testing in advanced cancer patients a capsaicin cousin that is 1,000 times more potent, to see if it can zap their intractable pain.

Specialists are watching the capsaicin research because it promises a one-time dose that works inside the wound, not body-wide, and wouldn’t tether patients to an IV when they’re starting physical therapy.

“It’s in and it’s done,” says Dr. Eugene Viscusi, director of acute pain management at Thomas Jefferson University in Philadelphia, one of the test sites. “You can’t abuse it. You can’t misuse it.”

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