European journal of pain : EJP
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Sensitisation of the pain detection system has been suggested to be involved in the pathogenesis of recurrent headache. In adults, increased sensitivity to pain has been found in patients with chronic tension type headache. Children with migraine or with unspecific headache report non-headache pains and interictal pericranial muscular tenderness more often than headache-free children. ⋯ Children with migraine experience more non-headache pains than children with episodic tension type headache and with no headache. However, neither children with migraine nor children with episodic tension type headache show increased interictal extracephalic muscular sensitivity for palpation.
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In this study we address the problem of the repeatability of autonomic responses in the experimental setting. In healthy volunteers, we measured the heart rate (HR) response to pain anticipation and to pain elicited with galvanic stimulation. ⋯ The parameters recorded included pain threshold, pain rating, HR response to pain anticipation and HR response to pain. We found a high correlation among the three sessions for all parameters, indicating that, as occurs for pain threshold and pain rating, individual differences in autonomic responses can be reliably reproduced as well, even though significant habituation develops.
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Clinical studies suggest that tramadol-induced analgesia is partially antagonized by ondansetron. ⋯ The interaction of tramadol with ondansetron or droperidol on antinociception can be antagonistic or additive, depending on the type of stimuli. Both anti-emetics antagonize the anti-transit effects of tramadol. The results demonstrate antagonism between tramadol and the two anti-emetics for analgesia and inhibition of gastrointestinal transit, supporting previous clinical studies.
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Sex differences in cardiac and autonomic response to clinical and experimental pain in LBP patients.
Rehabilitation professionals are currently using heart rate (HR) in order to assess the sincerity of effort in certain evaluations. It has been shown that a relation exists between HR and pain but no study has measured cardiac response during both clinical and experimental pain among a patient population using an intra-subject design. Thirty patients with low back pain (LBP) participated in this study including 16 men. ⋯ These results suggest that pain induced during a clinical evaluation will produce a significant HR augmentation. However, heart rate variability analysis showed greater sympathetic cardiac regulation for men. The sex differences observed in this study call for caution when interpreting HR during pain assessment.