The Clinical journal of pain
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Randomized Controlled Trial
The Benefit of Dexmedetomidine on Postoperative Cognitive Function is Unrelated to the Modulation on Peripheral Inflammation: A Single Center, Prospective, Randomized Study.
Dexmedetomidine potentially confers an advantage to reduce the incidence of postoperative delirium (POD) in surgical patients. Anti-inflammation is important effect of this sedative drug. In this study, we aimed to investigate whether the effect of dexmedetomidine on the postoperative cognitive function is via inhibiting peripheral inflammation. ⋯ Intraoperative sedation with dexmedetomidine conferred better postoperative neurocognitive function for elderly patients who received total knee arthroplasty. This effect was unrelated to the modulation of dexmedetomidine on peripheral inflammation.
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Somatosensory abnormalities are linked to clinical pain outcomes in individuals with spinal pain. However, a range of factors might confound the relationship between altered somatosensory function and clinical pain outcomes. This systematic review aimed to evaluate the literature to assess the level of evidence of associations between psychological, social, physical activity, and sleep measures and somatosensory function (assessed via sensory psychophysical testing) among individuals with spinal pain. ⋯ Psychological factors are associated negatively with pain thresholds and they need to be adjusted when establishing predictive relationships between somatosensory function and pain outcomes in individuals with spinal pain.
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Pain catastrophizing is an important predictor of pain-related outcomes. Caregiver and child levels of catastrophizing about child chronic pain are associated cross-sectionally, yet predictive associations testing interpersonal influences within caregiver-child dyads are lacking. The present study tested caregiver and child influences on partner catastrophizing about child pain over a period of 1 month following initiation of interdisciplinary pain treatment and examined whether the change in pain catastrophizing was associated with child pain interference. ⋯ In the short period following initial pain evaluation, caregivers and children evidenced reductions in pain catastrophizing, which were associated with increased child function. Findings highlight the important role of child cognitive-affective responses to pain in influencing caregiver catastrophizing about child pain. Understanding the individual contributions children and caregivers make to interpersonal pain processes will inform future family-level clinical interventions.
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The objective of this study was to evaluate the effect of repeated painful stimuli on short-term pain response in healthy, term, large for gestational age newborns by measuring the regional cerebral oxygen saturation (rScO2), and behavioral and physiological responses. ⋯ We showed that rScO2 values changed significantly within the first few days of life in babies who received more painful stimuli compared with the control group, similar to behavioral and physiological responses.
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Approximately 40% of children and adolescents with chronic pain report at least 1 dismissal experience, citing medical providers and parents as the primary and most distressing dismissers. Previous research indicates sex differences in pain dismissal experience and observer pain perception. This study examined parental reactions to dismissive provider-child scenarios and the influence of provider and patient sex on perceptions. ⋯ Parents consistently identified the dismissive language in a child and provider scenario. Female providers and sex-matched dyads seem to be more polarizing in terms of likelihood to bring their child to the provider and belief of pain, respectively. Providers within these groups may need to be especially cautious with their language when responding to pediatric chronic pain complaints.