Pain
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Variability of physiological parameters was used as a measure of stress in the newborn infant. There was a significant increase in variability of the heart rate (P < 0.01) when the stab of the heel prick occurred in addition to the other elements of the procedure (positioning, warming, alcohol swab cleansing and squeezing). This dummy procedure itself caused some increase in variability although this was not significant at the 5% level. There were similar significant increases in variability of the respiratory rate and O2 and CO2 tensions in the blood (P < 0.05) during the stab procedure.
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We have reviewed our experience with spinal cord stimulation in treating patients with the failed back surgery syndrome and have assessed patient and patient-selection characteristics as predictors of the long-term outcome. Neuroradiological investigations eliminated the possibility of a surgically treatable lesion and electromyogram assessed the chronic radicular suffering in correlation with the complaints and the clinical examination of the patient. Excellent pain relief (75% or more) during 1 week of trial stimulation and no major psychiatric or psychological pathology were criteria of selection. ⋯ Thirty-five patients (55%) continued to experience at least 50% of pain relief at the latest follow-up. Fifty-eight patients (90%) were able to reduce their medication, 39 patients (61%) reported a change in lifestyle, in that their ability to perform daily activities had improved significantly. Fifty-three patients (83%) continued to use their device at the latest follow-up.
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In multiple studies cultural affiliation has been found to have an important influence on perception of and response to experimental and acute pain. Despite that evidence little work has been directed to understanding the cultural dimensions of the chronic pain experience. We present the results of a quantitative study of reported chronic pain perception in 372 chronic pain patients in six ethnic groups, who were under treatment at a multidisciplinary pain-management center. ⋯ This study suggests a biocultural model may be useful in conceptualizing the complex interaction of biological, cultural and psychosocial factors in the process of human pain perception. Although it is likely that intense pain affects attitudes and emotions, it is also very likely that attitudes and emotions influence reported perceptions of pain intensity. Pain intensity variation in this study population is not significantly associated with diagnosis, present medication types, or types of past treatments or surgeries for pain.
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This study was designed to examine the central changes in the receptive field properties of dorsal horn neurones induced by a period of visceral noxious stimulation. The aim of this investigation was to establish whether noxious stimulation of the visceral input to the spinal cord could influence transmission of cutaneous information through dorsal horn neurones. Single-unit electrical activity was recorded in the lower thoracic spinal cord of anaesthetized cats from dorsal horn neurones with a somatic receptive field in the ipsilateral flank. ⋯ The increases were large and lasted for at least 20 min. None of the 9 spinal cord neurones without an input from the gall bladder were affected by the conditioning visceral stimulus even though 7 showed changes in receptive field size when the animals were spinalised. These results show that noxious stimulation of viscera can evoke increases in the somatic receptive fields of spinal cord neurones but only of those neurones which are also driven by the visceral stimulus.
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A number of facial actions have been found to be associated with pain. However, the consistency with which these actions occur during pain of different types has not been examined. This paper focuses on the consistency of facial expressions during pain induced by several modalities of nociceptive stimulation. ⋯ The findings suggest that the 4 actions identified carry the bulk of facial information about pain. They also provide evidence for the existence of a universal facial expression of pain. Implications of the findings for the measurement of pain expression are discussed.