European journal of pain : EJP
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The aim of the present study was to evaluate the efficacy of EMLA cream (containing a eutectic mixture of local anaesthetics) in controlling pain due to arteriovenous fistula cannulation in teenagers undergoing chronic haemodialysis. The study was conducted in two phases, one prospective, the other a blind randomized trial, at the Paediatric Haemodialysis service of the Paediatrics Department of Padua University, Italy. ⋯ Results showed that: (1) the visual analogue scale calls for an adequate training period; and (2) the EMLA cream might be effective in controlling cannulation-related pain but emotional factors, such as uncontrolled fear and stress, can interfere with the global efficacy of the analgesic approach. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.
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The characteristics of chest pain due to suspected acute myocardial infarction and morphine use during the first 3 hospital days are described in a population of 2988 consecutive patients admitted to hospital. The duration of pain was usually less than 24 h (mean 20.9+/-0.55 h), and only 24.8% of patients experienced chest pain of longer duration. The majority of patients had only one attack of pain, but 34.4% experienced four or more attacks during hospitalization. ⋯ When intravenous morphine is given, it attains full effect 20 min after injection. Furthermore, the active morphine metabolites M3G and M6G appear rapidly in the circulation, which could influence the analgesic response to morphine treatment. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.
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The tricyclic antidepressant imipramine has shown analgesic effect in human clinical and experimental pain studies. The aim of the present study was to test the effect of imipramine on a pure short-term nociceptive stimulus with pin-prick pain quality. In a randomized, placebo-controlled, double-blind, crossover study, the hypoalgesic effect of a single oral dose of 100 mg imipramine was investigated in 10 healthy volunteers. ⋯ This study demonstrates the important fact that a drug may show clear analgesic effect in some experimental pain models while it is without effect in other models; e.g. imipramine is known to affect pain tolerance and summation thresholds. Pre-clinical tests of potentially analgesic drugs should therefore be based on different pain-stimulation modalities. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.
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This study found that in lightly-anesthetized rats a unilateral micro-injection of glutamate (200 mm, 0.5 µl) into the thalamic nucleus submedius (Sm) markedly depressed the radiant heat-evoked tail flick (TF) reflex. After injection, the mean TFL increased 25.6+/-6.5% (n=24) of the baseline at 5 min, up to a peak value (48.4+/-7.2%) at 20 min, and recovered to the baseline level at 60 min. This inhibitory effect was dose-related and repeatable over a time interval of 1.0-1.5 h in the same animal. ⋯ These results confirmed our previous findings that electrical stimulation of Sm depressed the rat TF reflex and that this inhibitory effect was blocked by electrolytic lesion of the VLO or PAG. Therefore, the present study provides further support for the hypothesis that Sm plays an important role in modulation of nociception, and that its effects are mediated by the VLO-PAG pathway, leading to activation of the brainstem descending inhibitory system and depression of the nociceptive inputs at the spinal cord level. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.