Nitric oxide (NO) may be involved in the mechanisms of pain generation and transmission throughout the central and peripheral nervous systems (including brain and spinal cord and perivascular tissue and peripheral nerve terminals) and locally released pain mediators (including formation of inflammation and vascular edema). NO mechanisms are also involved in the analgesic activity of nonsteroidal anti-inflammatory drugs, opioids, and local anesthetics. These novel observations dictate new approaches to the pharmacologic treatment of migraine, neuropathic pain, and other forms of chronic, intractable pain that are resistant to classical pharmacotherapy.The new strategies of pharmacologic pain treatment are increasing rapidly due to the availability of new drugs modulating the NO-activated cascade and soon may be available for clinical use.
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Janicki, P.K., Jeske-Janicka, M. Relevance of nitric oxide in pain mechanisms and pain management. Current Review of Pain 2, 211–216 (1998). https://doi.org/10.1007/s11916-998-0022-5