European journal of pain : EJP
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Tramadol is a widely-used analgesic for pre- and post-operative pain which has a different pharmacological profile to that of classical opioids, since it does not induce respiratory depression, constipation, sedation, tolerance or dependence. However, tramadol frequently produces nausea and vomiting as side-effects. In the present study, the interactions between tramadol and several adrenergic and serotonergic compounds with antinociceptive activity were studied by isobolographic analysis. ⋯ The synergies observed with these combinations suggest a complex modulation of the descending noradrenergic and serotonergic systems that exert inhibitory influences on the transmission of nociceptive information, probably in addition to effects on receptors in the primary neurons of the spinal cord. The co-administration of analgesic drugs that produce superadditive effects constitutes a significant new avenue for the treatment of pain, since a similar level of antinociception can be obtained with considerable reductions in the dose of each analgesic. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.
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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 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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The aims of this study were: (1) to compare two groups of patients with chronic pain conditions (work-related muscular pain, mainly low back pain, and fibromyalgia) in general coping and pain-specific coping; (2) to examine the relationship between general and pain-specific coping and, (3) to examine the influence of state-trait anxiety on general and pain-specific coping. The sample included 80 individuals (range=19-70 years; mean=47; SD=9.9), who were patients at two pain management clinics for examination of their physical and psychosocial health conditions and consideration on disability pension. The patients were asked to respond to theStrategies to Handle Stress Questionnaire, theCoping Strategies Questionnaireand theState-Trait Anxiety Inventory. ⋯ Anxiety-prone patients with fibromyalgia might benefit from psychological support in the process of coping with pain. Copyright 1998 The British Infection Society. All rights reserved.