Pain
-
The ability of athletes to continue to compete despite sustaining painful injury is often interpreted as evidence for the activation of endogenous analgesia mechanisms. However, alterations in perception of noxious stimuli during competition have not yet been systematically investigated. This experiment evaluated experimental pain sensitivity in male and female athletes 2 days before, immediately following, and 2 days after competition. ⋯ Withdrawal latencies to noxious heat also were altered by competition, with finger withdrawal latency decreasing and arm withdrawal latency increasing in most athletes. No changes in pain report were observed across time in non-athlete controls. Competition induces both hyperalgesic and analgesic states that are dependent on the body region tested and pain assessment methodology used.
-
This study assessed the effects of two N-acylethanolamides in established rat models of visceral and somatic inflammatory pain. (1) The therapeutic effects of the cannabinoid anandamide and the putative CB2 agonist palmitoylethanolamide were tested in a model of persistent visceral pain (turpentine inflammation of the urinary bladder). Both anandamide (at a dose of 25 mg/kg) and palmitoylethanolamide (at doses of 10-30 mg/kg) were able to attenuate the viscero-visceral hyper-reflexia (VVH) induced by inflammation of the urinary bladder. (2) The effects of the same compounds on the behavioural response to subcutaneous formalin injection were assessed. The characteristic biphasic response was observed in control animals. ⋯ The results confirm the analgesic potential of endogenous ligands at cannabinoid receptor sites. The anti-nociceptive effect of the putative CB2 receptor agonist, palmitoylethanolamide, is particularly interesting since it is believed to be a peripherally mediated effect. This observation might be exploited to separate central psychotropic effects from peripheral analgesic actions of the cannabinoids, under inflammatory conditions.
-
Surgery and trauma are recognised as important causes of chronic pain, although their overall contribution has not been systematically studied. This paper reports on the contribution of surgery and trauma to chronic pain among 5130 patients attending 10 outpatient clinics located throughout North Britain. Surgery contributed to pain in 22.5% of patients, and was particularly associated with the development of pain in the abdomen and with anal, perineal and genital pain. ⋯ These findings indicate that it can be unhelpful for pain classification systems to combine surgery and trauma in a single category. The results also point to areas for potentially fruitful research into the aetiology of chronic pain. In particular, studies are needed to identify the operative procedures associated with the development of pain so that preventive measures can be implemented.
-
Gabapentin (GP) has been shown to have antihyperalgesic properties and the site of drug action is reported to be the central nervous system. The goal of the present study was to determine whether GP also has a peripheral site of action. ⋯ The antihyperalgesic effect of GP (1) was not due to a systemic effect since animals injected with 600 microg GP in one hindpaw and 2% formalin into the contralateral hindpaw developed nociceptive behaviors which were no different than those seen in animals injected with formalin alone; (2) was not due to a local anesthetic effect since needle sticks within the drug-injected region evoked paw withdrawal behavior which was not different from pre-drug levels; (3) was blocked by 20 microl D-serine but not by L-serine. Although the mechanism of action of GP has yet to be elucidated, these results indicate that GP has a peripheral site of action and thus may offer a novel therapeutic agent for topical or local treatment of pain of peripheral origin.
-
Randomized Controlled Trial Clinical Trial
Nimodipine-enhanced opiate analgesia in cancer patients requiring morphine dose escalation: a double-blind, placebo-controlled study.
The ability of nimodipine, a dihydropyridine calcium antagonist, to reduce the daily dose of oral morphine in cancer patients who had developed dose escalation, was tested in 54 patients under randomized, double-blind, placebo-controlled conditions. We selected patients that required at least two successive increments of morphine to maintain pain relief. A possible pharmacokinetic interaction between nimodipine and morphine was also studied in 14 patients by assaying steady-state serum levels of morphine and its 3- and 6-glucuronides. ⋯ One week after introducing nimodipine or placebo, while the dose of morphine remained similar to that of the pre-test week, the serum levels of morphine and its glucuronides were not modified significantly. We conclude that the introduction of nimodipine in patients chronically treated with morphine may be a safe alternative to reduce the daily requirements of the opioid. It is suggested that interference with Ca2+-related events may attenuate the development and/or expression of tolerance to morphine in a clinically relevant way.