NEW COMPOUNDS WITH ANALGESIC AND LOCAL ANAESTHETIC EFFECT

Abstract: New compounds of formula (A), a process for their preparation and their use in the manufacture of pharmaceutical preparations. The new compounds have both local anaesthetic and analgesic effect.

Description: New compounds with analgesic and local anaesthetic effect Field of the invention The present invention is directed to new compounds having both local anaesthetic and analgesic effect, a process for their preparation and their use in the manufacture of pharmaceutical preparations. Background of the invention Pethidine is a frequently used analgesic,but its local anaesthetic effect is weak. The anaesthetic/analgesic effect of pethidine after spinal administration is often insufficient in both respects. Instead combinations of bupivacaine and fentanyl or morphine are being used. The opiate analgesics have several severe drawbacks, e.g. development of tolerance, addiction, risk for respiratory depression. There is, thus, a need for agents giving a local anaesthesia with a remaining analgesic effect having less side-effects than the currently used combinations. Such agents should be used after spinal or epidural injections as local anaesthetics intraoperatively. Thereafter the compounds would give good post-operative pain relief. Prior art Hardy D G et al, describe in J.Med.Chem. 8., pp 847-851 (1965) the structure-activity relationship of certain analogues of pethidine, which are disclosed as having an analgesic activity. The Swedish patent 96980 describes 1- methyl-4-phenyl-piperidine-4-carboxylic acid and two amides thereof, but does not disclose any specific pharmaceutical effect, only that the compounds can be used in the manufacture of new drugs. From WO SE90/00818 certain substituted 4-phenyl- piperidine-4-carboxamides are described as having both local anaesthetic and analgesic effects. Outline of the invention The novel compounds according to the present invention are defined by the following formulae (A) : wherein Z is a group taken from the left to the right direction in formula (A) or a carbonyl group; and wherein: a) R-*L is hydrogen or a straight or branched alkyl group with 1-3 carbon atoms, and R2 is a straight or branched alkyl group with 1-3 carbon atoms, or b) R-*_ and R 2 form together a chain -(CH 2 ) n -, wherein n is 3,4 or 5, or -(CH 2 ) 2 0(CH 2 ) 2 " m is 0-1; p is 1-2; R3 is hydrogen or -COCH3; and R4 is hydrogen, -CH3, -OH or -OCH3, with the proviso that when Z is a carbonyl group, p is 2, as well as the pharmaceutically acceptable salts of the compounds of formulae (A) . R4 may be present in 2-, 3- or 4-position. Preferred compounds according to the invention are those wherein R4 (in the benzene ring which is coupled to the group Z) is in the 2-position and wherein R4 is hydrogen, m is 0, R3 is hydrogen, p is 2, and R^ and R 2 are the same being an ethyl group; or R4 is hydrogen, m is 0, R3 is hydrogen, p is 2, R^ is a methyl group and R is an ethyl group; or R4 is hydrogen, m is 0, R3 is hydrogen, p is 2, and wherein R-^ and R 2 together form a chain -(CH 2 )-4; or R4 is hydrogen, m is 0, R3 is hydrogen, p is 2, R- j _ is a methyl group and R 2 is an isopropyl group; or R4 is a methoxy group, is 0, R3 is hydrogen, p is 2, R^ is a methyl group and R 2 is an ethyl group; or R4 is a methyl group, m is 0, R3 is hydrogen, p is 2, R^ is a methyl group and R 2 is an ethyl group; or R4 is hydrogen, m is 0, R3 is hydrogen, p is 1, and R- ] _ and R 2 are the same being an ethyl group. Preferred salts according to the invention are pharmaceutically acceptable salts. The hydrochloride is especially preferred. Citrate, methansulfonate and maleate are other examples of salts which can be used. The compounds according to the present invention are more suitable to use in pain management, because they are less toxic and more effective as local anaesthetics and analgesics. Compounds of the formulae A and pharmaceutically acceptable salts thereof not only give an unexpectedly good effect as spinal and epidural anaesthetics, but also have an additional analgesic effect that lasts a long time after the anaesthetic effect has declined. Thus no combination of active compounds need to be given and the risks connected with these combinations can be avoided. The compounds also give an unexpectedly superior effect to the known compounds having this kind of combination effects. The most preferred compounds according to the invention known at present, are the compounds according to Example 13 and Example 6A, i.e. compounds of the formula XIII, and compounds of the formula VI wherein R4 is H, R- j _ and R 2 are both -C 2 Hc;; R4 is H, R-L is -CH3 and R 2 is -C 2 H 5 ; R4 is H and R^ + R 2 is -(CH 2 )4,- R4 is H, R-L is -CH3 and R 2 is isopropyl; R 4 is 2-OCH3, R± is -CH3 and R is -C 2 H 5 , R4 is 2-CH3, R-L is -CH3 and R 2 is -C 2 H 5 ; Preparation For preparing the substituted piperidine-4-carboxamides of formula (A) according to the invention, the compounds could be divided into six groups which were prepared according to Schemes 1-5. The first group, aromatically unsubstituted 1-(3-acetoxy- 3-phenyl-propyl) -4-phenyl-piperidine-4-carboxamides (V) , and the second group 1-(3-hydroxy-3-phenyl-propyl)-4- phenyl-piperidine-4-carboxamides (VI) , were prepared according to the following reaction scheme: Scheme 1 IV wherein R^ and R 2 are as defined above, The aminoketone I was prepared by a Mannich reaction of 4-phenyl-piperidine-4-carbonitrile with formaldehyde and acetophenone. The carbonyl group of I was reduced with sodium borohydride to give the secondary alcohol II. Hydrolysis of the cyano group under alkaline conditions gave the amino acid III. The hydroxyl group was acetylated, and the carboxylic acid IV was converted to the appropriate amide V via the acid chloride. Selective alkaline hydrolysis of the ester group of compounds V yielded the corresponding secondary alcohols VI. Enantiomeric pure forms of compound VI, wherein R-^ is - CH3 and R 2 is -C 2 H 5 or R- j _ and R 2 are the same being -C 2 H 5 were prepared according to the following reaction scheme: Scheme 2 VII (R)- or (S) - VI 4-Phenyl-piperidine-4-carbonitrile was benzylated to give the aminonitrile VII, which was hydrolyzed under alkaline conditions to the amino acid VIII. The acid was converted to the appropriate amide IX via the acid chloride. Hydrogenolysis of the benzylamines in the presence of palladium catalyst gave the secondary amines X, which were alkylated with either (R) - or (S) -3-chloro-l-phenyl- 1-propanol to give the two enantiomeric pairs of VI wherein R-^ is -CH3 and R 2 is -C Hg or R- j _ and R 2 are the same being -C 2 Hς. Aromatically substituted piperidine-4-carboxamides wherein R- | _ is -CH , R is -C Hι*-* and R4 is -CH3, -OH or -OCH3 comprise, together with compound XI wherein R-^ and R 2 are the same being -C 2 H 5 , and R 4 is hydrogen, the third (ketones XI) and fourth (alcohols VI) groups of new compounds. These were prepared according to the following reaction scheme: Scheme 3 rrάMO A Mannich reaction between the secondary amine X, wherein R**L is -CH 3 and R 2 is -C 2 H 5 or R-^ and R are the same being -C H 5 , formaldehyde and the appropriate benzophenone, with R being hydrogen, -CH3 or -OCH3, gave the ketones XI. The carbonyl group of the aromatically substituted ketones XI (R 4 is -CH3, -OCH3 or -OH) was reduced with sodium borohydride to give the alcohols VI. Compound XI wherein R is 2-hydroxy was prepared from the corresponding methoxy compound by demethylation with boron tribromide. 1-(2-Hydroxy-2-phenyl-ethyl) -4-phenyl-piperidine-4- carboxylic acid diethylamide (XIII) , the fifth type of new compounds, was prepared according to the following reaction scheme: Scheme 4 The secondary amine X wherein R- j _ and R 2 are the same being -C 2 H 5 was alkylated with phenacyl bromide to give the ketone XII, which was reduced with sodium borohydride to the secondary alcohol XIII. The sixth group of compounds, 1-(2-hydroxy-3-phenyl- propyl) -4-phenyl-piperidine-4-carboxamides (XVIII) were prepared according to the following reaction scheme: Scheme 5 XIV XV wherein R- j _ and R are as defined above. 4-Phenyl-piperidine-4-carbonitrile was alkylated with (2,3-epoxypropyl)benzene to give the secondary alcohol XIV. Compounds XV, XVI, XVII and XVIII were prepared as described for compounds III, IV, V and VI respectively. Detailed description of the preparations The following examples (Arabic numerals) describe in detail the preparation of the compounds (referred to by the same Roman numeral) according to the invention. Example 1 Preparation of 1-(3-oxo-3-phenyl-propyl) -4-phenyl- piperidine-4-carbonitrile (Compound I) A mixture of 4-phenyl-piperidine-4-carbonitrile hydrochloride (41.6 g, 187 mmol) , formaldehyde (8.4 g, 280 mmol), acetophenone (33.6 g, 280 mmol) and 37% hydrochloric acid (2 ml) in ethanol (500 ml) was refluxed for 48 h. After cooling precipitated material was collected by filtration, yielding 40.0 g of the hydrochloride with m.p. 207-210 °C. Example 2 Preparation of 1- (3-hydroxy-3-phenyl-propyl) -4-phenyl- piperidine-4-carbonitrile (Compound II) The ketone I (48.2 g, 136 mmol) and sodium borohydride (20.0 g, 526 mmol) suspended in ethanol (500 ml) was heated at 50 °C for 15 h. The solvent was evaporated and 2N hydrochloric acid (150 ml) was slowly added. The solution was then alkalized with 5N sodium hydroxide and extracted with three portions of chloroform (3 x 100 ml) . The combined extracts were dried over potassium carbonate, filtered and the solvent was evaporated. Yield 41.0 g, with m.p. 109-112 °C. Example 3 Preparation of 1-(3-hydroxy-3-phenyl-propyl) -4-phenyl- piperidine-4-carboxylic acid (Compound III) A solution of the nitrile II (20.3 g, 63 mmol) and potassium hydroxide (17.5 g, 313 mmol) in ethanol (50 ml) and water (80 ml) was heated in an autoclave at 140 °C for 6 h. After cooling the solution was evaporated to one third of its original volume and then acidified with hydrochloric acid to pH 2. The precipitate was collected by filtration. Yield 22.0 g of the hydrochloride with m.p. 280 °C. Example 4 Preparation of 1- (3-acetoxy-3-phenyl-propyl) -4-phenyl- piperidine-4-carboxylic acid (Compound IV) A mixture of compound III (11.3 g, 30 mmol), acetic anhydride (200 ml) and 4-dimethylaminopyridine (0.3 g) was heated at 50 °C for 15 h. The solvent was evaporated and the residue was carefully dried at 80 °C in a vacuum cabinet and then recrystallized from dioxane. Yield 10.2 g of the hydrochloride with m.p. 189-193 °C. Example 5 Preparation of 1- (3-acetoxy-3-ρhenyl-propyl) -4-phenyl- piperidine- -carboxamides (Compounds V) Oxalyl chloride (6 ml) was added dropwise with stirring to a suspension of the piperidinecarboxylic acid IV (5.0 g, 12 mmol) in dichloromethane (100 ml) . The reaction mixture was stirred at 50 °C for 2 h. The solvent was evaporated, a few ml of toluene were added and the solvent was evaporated again. The residue was dissolved in dichloromethane (50 ml) and the solution was added dropwise with stirring to a solution of the appropriate amine (36 mmol) in dichloromethane (20 ml), cooled in ice-water. The reaction mixture was stirred at room temperature for 4 h. The solvent was evaporated and the residue was shaken between dilute sodium hydroxide (20 ml) and dichloromethane (3x20 ml) . The organic extract was dried over potassium carbonate, filtered and evaporated to dryness . Hydrochlorides were prepared by addition of hydrogen chloride in diethyl ether to etheral solutions of the amines. The compounds were recrystallized from the appropriate solvent (Table 1) . Example 6A Preparation of 1- (3-hydroxy-3-phenyl-propyl) -4-phenyl- piperidine-4-carboxamides (Compounds VI) A suspension of the ester V (12 mmol) in 2N sodium hydroxide (60 ml) and ethanol (40 ml) was heated at 70 °C for 3 h. The solution was evaporated to half its original volume and then extracted with three portions of diethyl ether (3x50 ml) . The ether extract was dried over potassium carbonate, filtered, and the hydrochloride was prepared as described in Example 5. The compounds were purified by recrystallization from the indicated solvent (Table 1) . Example 7 Preparation of 1-benzyl-4-phenyl-piperidine-4- carbonitrile (Compound VII) A mixture of 4-phenyl-piperidine-4-carbonitrile (41.4 g, 223 mmol), benzyl bromide (41.9 g, 245 mmol) and sodium carbonate (29.7 g, 281 mmol) in 1-butanol (300 ml) was stirred at room temperature for 12 h. The solvent was evaporated and IN sodium hydroxide (100 ml) was added. The water phase was extracted three times with dichloromethane (3x 150 ml) . The combined extracts were dried over potassium carbonate, filtered and evaporated to dryness. Yield 59.0 g with m.p. 76-79 °C. Example 8 Preparation of l-benzyl-4-phenyl-piperidine-4-carboxylic acid (Compound VIII) The nitrile VII (20.0 g, 73 mmol) was hydrolyzed in an autoclave as described in Example 3. The reaction mixture was evaporated to one third of its original volume and neutralized with hydrochloric acid. Precipitated material was collected by filtration, yielding 18.6 g of the amino acid with m.p. 288-290 °C. Example 9 Preparation of l-benzyl-4-phenyl-piperidine-4- carboxamides (Compounds IX) The carboxylic acid VIII was converted to the appropriate amide as described for compounds V. The amide with R-**_ being -CH3 and R 2 being -C 2 Hc** was isolated as the free base, recrystallized from ethyl acetate and obtained in 62% yield with m.p. 108-112 °C. The amide wherein R 1 and R 2 are the same being -C H5 was isolated as the hydrochloride and recrystallized from a mixture of acetonitrile and ethyl acetate. Yield 54% with m.p. 204- 206 °C. Example 10 Preparation of 4-phenyl-piperidine-4-carboxamides (Compounds X) A solution of the appropriate tertiary amine IX (13 mmol, obtained from the hydrochloride in the usual way) in methanol (200 ml) was hydrogenated at atmospheric pressure in the presence of 5% palladium on activated carbon (100 mg) until the calculated amount of hydrogen had been consumed. The catalyst was removed by filtration and the solvent was evaporated. The hydrochlorides were prepared as described in Example 5 and recrystallized from acetonitrile. The amide with R- j _ being -CH3 and R being -C 2 H 5 was obtained in 94% yield with m.p. 214-217 °C, and the amide wherein R- j _ and R are the same being -C 2 H 5 in 91 % yield with m.p. 238-240 °C. Example 6B Preparation of optically active 1- (3-hydroxy-3-phenyl- propyl) -4 phenyl-piperidine-4-carboxamides (Compounds VI wherein R-*_ is -CH3 and R 2 is -C 2 H 5 or R-^ and R 2 are the same being . A mixture of the appropriate amine X (4.0 mmol, obtained from the hydrochloride in the usual way), (R) -3-chloro-l- phenyl-1-propanol (0.70 g, 4.12 mmol; prepared according to Brown H C et al in J.Org.Chem. j53_ pp. 2916-2920 (1988)) or the (S) -enantiomer (of commercial origin), sodium carbonate (0.46 g, 4.3 mmol) and potassium iodide (50 mg) in 1-butanol (20 ml) was refluxed for 30 h. The solvent was evaporated and 0.5 N sodium hydroxide (10 ml) was added. The water phase was extracted three times with diethyl ether (3x20 ml) . The combined extracts were dried over potassium carbonate and filtered. The hydrochloride was precipitated as described in Example 5. The salts were recrystallized from the indicated solvent (Table 1) . The optical rotations I [α]* °, (c = mg/ml)J obtained in absolute ethanol are as listed: R l R 2 (R) -VI (S)-VI CH 3 C 2 5 + 22.2° (10.0) - 23.4° (10.0) 2 H 5 C 2 H 5 + 20.4° ( 2.8) - 21.8° ( 2.8) Table 1 Hydrochlorides of compounds V and VI R l R 2 m.p. of V [°C] , m.p. of VI [°C], (xx solvent) , (xx solvent) , yield % yield % H C 3 H 7 158-160, (b) ,60 185-190, (a), 75 CH 3 CH 3 197-198, (b) ,69 192-194, (a) ,51 CH 3 C 2 H 5 208-210, (b) ,45 [racemic] : 149, (a) , 45 CH 3 C 2 H 5 - (R) :178-181, (a) ,58 CH 3 C 2 H 5 - (S) -179-181, (a) ,53 2 H 5 C 2 H 5 218-220, (b),96 [racemic] :135- 138, (b) ,80 C 2 H 5 C 2 H 5 - (R) :169-170, (b) ,60 C 2 H 5 2 H 5 - (S) :165-167, (b) ,55 CH 3 CH(CH 3 ) 2 195-197, (b),60 143-147, (b) ,45 C 2 H 5 CH(CH 3 ) 2 198-204, (b),50 168-171, (a) ,45 CH(CH 3 ) 2 CH(CH 3 ) 2 217-219, (b) ,45 148-152, (b) ,21 " (CH 2 ) 3 - 175-182, (b) ,73 214-215, (b) ,75 " <CH 2 ) 4 - 197-201, (b) ,45 232-235, (a) ,46 20 R l R 2 m.p. of V [°C] , m.p. of VI [°C], (xx solvent) , (xx solvent) , yield % yield % - ( H 2 ) 5 " 190-191, (b) ,31 188-190, (b),74 - (CH 2 ) 2 0(CH 2 ) 2 - 221-222, (b) ,32 210-212, (a), 67 Recrystallization solvent: (a) = acetonitrile (b) = ethyl acetate Example 11A Preparation of 1- (3-oxo-3-phenyl-propyl) -4-phenyl- piperidine-4-carboxamides (Compounds XI) Mannich reactions performed as described in Example 1 between the amine X with R- j _ being -CH3 and R 2 being -C H 5 or R-^ and R are the same being -C Hς, formaldehyde, and the appropriate acetophenone with R4 being hydrogen, 2- OCH3, 3-OCH3, 4-OCH3 or 2-CH3 gave the corresponding ketones XI . Compound XI wherein R-^ and R 2 are the same being -C 2 H 5 and R4 being hydrogen, was recrystallized from acetonitrile. Yield 70 %, with m.p. 189-192 °C. The aromatically substituted ketones XI were recrystallized from the indicated solvent and had the m.p.s given in Table 2. Example 11B Preparation of 1- f3- (2-hydroxy-phenyl) -3-oxo-propyll -4* phenyl-piperidine-4-carboxylic acid ethyl-methyl-amide (Compound XI wherein R-^ is -CH3 , R is -C 2 Htr and R 4 is 2-OH) To a solution of compound XI wherein R4 is 2-OCH3 (1.3 g, 2.9 mmol) in dichloromethane (25 ml) cooled in ice-water was added 0.5 M boron tribromide (15 ml, 7.5 mmol) in dichloromethane, and the mixture was stirred at room temperature for 24 h. The dichloromethane solution was shaken with dilute ammonia and the organic phase was separated and dried over sodium sulfate. The solvent was evaporated and the residual base converted to hydrochloride as described in Example 5 (Table 2) . Yield 1.0 g. Example 6C Preparation of aromatically substituted 1- (3-hydroxy-3* phenyl-propyl) -4-phenyl-piperidine-4-carboxylic acid ethyl-methyl-amides (Compounds VI) The ketone XI wherein R 4 is 2-OCH3, 3-OCH3, 4-OCH3, 2-CH3 or 2-OH (1 mmol) and sodium borohydride (6 mmol) were suspended in tetrahydrofurane and stirred at room temperature for 48 h. The product was isolated as described in Example 2 , and the hydrochloride was prepared as described in Example 5. Recrystallization solvents and m.p.s are given in Table 2. Table 2 Hydrochlorides of the aromatically substituted piperidine-4-carboxylic acid ethyl-methyl-amides XI and VI. R 4 m.p . of XI [°C] , m.p. of VI [°C] , (xx solvent ) , yield % (xx solvent ) , yield % 2 -OCH 3 208-210 , (a) , 54 176-180 , (a) , 75 R 4 m.p. of XI [°C], m.p. of VI [°C], (xx solvent), yield % (xx solvent), yield % 3-OCH 3 205-207, (a) ,50 124-127, (b),75 4-OCH 3 208-209, (a) ,36 - 2-CH 3 198-200, (a) ,50 185-189, (b),60 2-OH 185-187, (a) ,79 206-210, (a) ,50 Recrystallization solvent: (a) = acetonitrile (b) = ethyl acetate Example 12 Preparation of 1- (2-oxo-2-phenyl-ethyl) -4-phenyl* -piperidine-4-carboxylic acid diethylamide (Compound XII) A mixture of the secondary amine X wherein R _ and R are the same being -C 2 H 5 (1.0 g, 3.8 mmol) , phenacyl bromide (0.81 g, 4.1 mmol) and sodium carbonate (1.0 g, 9.4 mmol) in 1-butanol was stirred at room temperature for 5 days. The product was isolated as described in Example 7. The hydrochloride was prepared as described in Example 5. Recrystallization from a mixture of acetonitrile and dioxane gave 0.8 g with m.p. 209-212 °C. Example 13 Preparation of 1- (2-hydroxy-2-phenyl-ethyl) -4-phenyl* piperidine-4-carboxylic acid diethylamide (Compound XIII) A mixture of the ketone XII (0.5 g, 1.2 mmol, converted to the free amine in the usual way) and sodium borohydride (0.3 g, 7.9 mmol) in tetrahydrofurane (20 ml) was stirred at room temperature for 4 days. The product was isolated as in Example 2. The hydrochloride was precipitated as described in Example 5 and the product was recrystallized twice from a mixture of acetonitrile and ethyl acetate. Yield 0.2 g with m.p. 203-205 °C. Example 14 Preparation of 1- (2-hydroxy-3-phenyl-propyl) -4-phenyl- piperidine-4-carbonitrile (Compound XIV) A mixture of 4-phenyl-piperidine-4-carbonitrile (6.3 g, 34 mmol) and (2.3-epoxypropy1)benzene (5.0 g, 37 mmol) in dioxane was refluxed for seven days . The solvent was evaporated and the residue was shaken between dilute sodium hydroxide and diethyl ether. The ether extract was dried over potassium carbonate, filtered and the product was converted to the hydrochloride as described in Example 5. Recrystallization from a mixture of ethanol and acetonitrile gave 10.0 g with m.p. 246-249 °C. Example 15 Preparation of 1- (2-hydroxy-3-ρhenyl-propyl) -4-phenyl- piperidine-4-carboxylic acid (Compound XV) The nitrile XIV (10.0 g, 28.1 rnmol) was hydrolyzed in an autoclave as described in Example 8. Yield 9.5 g of the amino acid with m.p. 288-290 °C. Example 16 Preparation of 1- (2-acetoxy-3-phenyl-propyl) -4-phenyl- piperidine-4-carboxylic acid (Compound XVI) The secondary alcohol XV (2.0 g, 5.9 mmol) was acetylated as described in Example 4. Recrystallization from dioxane gave 2.0 g of the amino acid with m.p. 179-182 °C. Example 17 Preparation of 1- (2-acetoxy-3-phenyl-propyl) -4-phenyl- piperidine-4-carboxamides (Compounds XVII) The carboxylic acid XVI was converted to the appropriate amides as described for compounds V. The hydrochlorides were recrystallized from ethyl acetate. The amide wherein R- | _ is -CH 3 and R 2 is -C 2 H 5 was obtained in 83% yield with m.p. 185-187 °C, and the amide wherein R-^ and R 2 are the same being -C 2 H 5 in 75% yield with m.p. 164-167 °C. Example 18 Preparation of 1- (2-hydroxy-3-phenyl-propyl) -4-phenyl- piperidine-4-carboxamides (Compounds XVIII) The esters XVII were hydrolyzed as described in Example 6A. The hydrochlorides were recrystallized from a mixture of acetonitrile and ethyl acetate. Compound XVIII wherein R-L is -CH3 and R 2 is -C 2 H 5 was obtained in 60% yield with m.p. 171-175°C, and XVIII wherein R and R 2 are the same being -C 2 H 5 in 55% yield with m.p. 166-169 °C . Pharmaceutical preparations For the preparation of pharmaceutical formulations one of the new compounds is dissolved in a liquid diluent, which is suitable for injection, e.g. physiological saline. The preparations used are aqueous solutions which contain between 0.1-100 mg/ml, preferably 3-20 mg/ml of the active compund calculated as the hydrochloride salt . Biological studies Spinal anaesthesia The compounds according to the invention were tested for spinal anaesthesia in the mouse. There were six animals in each group. As reference co pund pethidine was used. Mean duration (min) of motor block and full analgesia (tail-flick) in mice after intrathecal (spinal) injection of 5 μl of the test solution was measured. The durations were calculated from the time of injection. Discussion As the local anaesthetic effect is potently combined with an analgesic effect, the compounds according to the invention should be more useful than pethidine. It should also be possible to replace the frequently used combinations of one analgesic and one anaesthetic agent.

Claims: CLAIMS 1. Compounds of the formula (A) wherein Z is a group taken from the left to the right direction in formula (A), or a carbonyl group; and wherein: R-**_ is hydrogen or a straight or branched alkyl group with 1-3 carbon atoms, and R 2 is a straight or branched alkyl group with 1-3 carbon atoms, or R- j _ and R form together a chain -(CH ) n -, wherein n is 3,4 or 5, or - (CH 2 ) 2 0(CH 2 ) 2 -; m is 0-1; p is 1-2; R3 is hydrogen or -COCH ; and R4 is hydrogen, -CH3, -OH or -OCH3, with the proviso that when Z is a carbonyl group, p is 2, as well as pharmaceutically acceptable salts thereof. 2. A compound according to claim i, wherein Z is where R3 is —C—CH 3 R4 is hydrogen, m is 0, p is 2, and wherein R- j _ and R are as defined in claim 1. 3. A compound according to claim 1, wherein Z is where R3 is hydrogen, R 4 is hydrogen, m is 0, p is 2 and wherein R- j _ and R are as defined in claim 1. 4. A compound according to claim 1, wherein Z is a carbonyl group, p is 2, R-^, R 2 and R4 are as defined in claim 1. 5. A compound according to claim 1, wherein Z is where R3 is hydrogen, m is O, p is 2 and wherein R-^, R 2 and R4 are as defined in claim 1. 6. A compound according to claim 1, wherein Z is where R is hydrogen, R4 is hydrogen, m is l, p is 1, and wherein R-^ and R 2 are as defined in claim 1. 7. A compound according to claim 1, wherein R is in 2- position. 8. A compound according to claim 3, wherein R- ] _ and R is each an ethyl group. 9. A compound according to claim 3, wherein R-<_ is a methyl group and R 2 is an ethyl group. 10. A compound according to claim 3, wherein R η and R 2 together form a chain -(CH 2 )-4. 11. A compound according to claim 3, wherein R^ is a methyl group and R 2 is an isopropyl group. 12. A compound according to claim 1 and 7, wherein R-<_ is a methyl group, R is an ethyl group, R3 is hydrogen, R4 is a methoxy group, m is 0 and p is 2. 13. A compound according to claim 1 and 7, wherein R- j _ is a methyl group, R 2 is an ethyl group, R3 is hydrogen, R4 is a methyl group, m is 0 and p is 2. 14. A compound according to claim 1, wherein R- j _ and R 2 is each an ethyl group, R3 is hydrogen, R is hydrogen, m is 0 and p is 1. 15. A compound according to claim 3, which is in the (R)- form, and wherein R ] _ is a methyl group and R 2 is an ethyl group. 16. A compound according to claim 3, which is in the (R) - form, and wherein R- j _ and R 2 is each an ethyl group. 17. A compound according to claim 3, which is in the (S)- form, and wherein R- j _ is a methyl group and R is an ethyl group. 18. A compound according to claim 3, which is in the (S)- form, and wherein R- ] _ and R 2 is each an ethyl group. 19. A compound according to claim 1, wherein the pharmaceutically acceptable salt is hydrochloride. 20. A compound according to claim 2, in form of its hydrochloride. 21. A compound according to claim 3, in form of its hydrochloride. 22. A compound according to claim 1 for use in therapy. 23. A pharmaceutical preparation containing a compound according to claim 1 or a pharmaceutically acceptable salt thereof as an active ingredient, together with a pharmaceutically acceptable carrier. 24. A pharmaceutical preparation according to claim 23, wherein the amount of the active ingredient is in the range 0.1-100 mg/ml, preferably 3-20 mg/ml. 25. A pharmaceutical preparation according to claim 23, used for controlling nerve blockade by administration epidurally or intrathecally. 26. A pharmaceutical preparation according to claim 23 with analgesic and local anaesthetic effect. 27. A pharmaceutical preparation according to claim 23 with analgesic effect. 28. Use of a compound according to claim 1, for the manufacture of a pharmaceutical preparation with analgesic effect. 29. Use of a compound according to claim 1, for the manufacture of a pharmaceutical preparation with analgesic and local anaesthetic effect. 30. A method for the treatment of a subject suffering from pain, whereby an effective amount of a compound according to claim 1 is administered to the subject suffering from pain. 31 31. A process for the preparation of a compound of Formula (A) according to claim 1, and pharmaceutically acceptable salts thereof, wherein a) an aminoketone of the formula I is prepared by a Mannich reaction of 4-phenyl- piperidine-4-carbonitrile with formaldehyde and acetophenone, whereafter the carbonyl group of I is reduced with sodium borohydride giving the secondary alcohol II, whereafter hydrolysis of the cyano group under alkaline conditions gives the amino acid III, and in which compound III the hydroxyl group is acetylated to an ester IV IV and the carboxylic group of IV is converted to the appropriate amide V via the acid chloride, whereby selective alkaline hydrolysis of the ester group of compounds V yields to give a compound of the formula (A) , wherein R is hydrogen, Z is OIH , p is 2 and R-^ and R 2 is as defined above; or 4-phenyl-piperidine-4-carbonitrile is benzylated giving the aminonitrile VII which is hydrolyzed under alkaline conditions to the amino acid VIII VIII whereafter VIII is converted to the appropriate amide IX via the acid chloride, and hydrogenolysis of the benzylamines is performed in the presence of palladium catalyst, giving the secondary amines X X which are alkylated with (R) - or (S) -3-chloro-l- phenyl-1-propanol, giving the two enantiomeric pairs of VI, or the secondary amine X is subjected to a Mannnich reaction with formaldehyde and the appropriate benzophenone, giving whereafter the carbonyl group of XI is reduced with sodium borohydride giving the compound of the formula VI; or the secondary amine X is alkylated with phenacyl bromide to give the ketone XII XII which is thereafter reduced with sodium borohydride giving the secondary alcohol XIII, which is a compound according to (A) , where R 4 is hydrogen, p is 1, Z is OiH and R-t and R-, are —-CH— ■ *- Δ each C 2 H 5 , or 4-phenyl-piperidine-4-carbonitrile is alkylated with (2, 3-epoxypropyl)benzene giving the secondary alcohol XIV XIV whereafter XIV is converted to XVIII XVIII which is a compound according to formula (A) , where R Λ IS hydrogen, Z is , p is 1 and R-i and R 2 are as defined above, exactly as described for compounds III, IV, V and VI under a) above, and if appropriate a compound obtained according to one of the process a) - e) above is converted to its pharmaceutically acceptable salt.

Inventors: ASK ANNA-LENA, OLSSON LARS-INGE, SANDBERG RUNE, ASK, ANNA-LENA, OLSSON, LARS-INGE, SANDBERG, RUNE
Applicants: ASK ANNA LENA, ASTRA AB, OLSSON LARS INGE, SANDBERG RUNE, ASK, ANNA-LENA, ASTRA AKTIEBOLAG, OLSSON, LARS-INGE, SANDBERG, RUNE
Application year: 1995
Main classification: C07D211
IPC codes: A61K31, A61P23, A61P25, A61P29, C07D211, C07D401, C07D413