European journal of pain : EJP
-
Randomized Controlled Trial
Acupuncture analgesia for temporal summation of experimental pain: a randomised controlled study.
Temporal summation of pain, a phenomenon of the central nervous system (CNS), represents enhanced painful sensation or reduced pain threshold upon repeated stimulation. This pain model has been used to evaluate the analgesic effect of various medications on the CNS. ⋯ EA induces bilateral, segmentally distributed and prolong analgesia on both SPT and TST, indicating a non-centrally specific effect. This effect needs to be verified with heat or mechanical model and in pain patients.
-
Recent developments within CBT have emphasized acceptance rather than control of pain and distress in treatments aimed at improving functioning and life quality, but there is still a lack of reliable and valid instruments to assess relevant processes in such interventions. The Psychological Inflexibility in Pain Scale (PIPS) was developed to assess target variables in exposure and acceptance oriented treatments. A preliminary validation study resulted in a two-factor solution with subscales for avoidance and cognitive fusion related to pain, showing satisfactory psychometric properties. ⋯ Notably, hierarchical regression analyses illustrated that PIPS explained more variance than TSK in pain, disability, life satisfaction and depression. Furthermore, PIPS was found to mediate the relationship between e.g. pain and disability, suggesting the usefulness of PIPS as a process measure in treatments of people with chronic pain. Thus, it is argued that this 12-item version of PIPS may be used to explore the importance of psychological in/flexibility in chronic pain and to analyse processes of change in exposure based interventions, as well as for clinicians in tailoring interventions for patients with chronic debilitating pain.
-
Multicenter Study
Influence of risk of neurological impairment and procedure invasiveness on health professionals' management of procedural pain in neonates.
To describe how (i) risk of neurological impairment (NI) and (ii) procedure invasiveness influence health professionals' assessment and management of procedural pain in neonates in the Neonatal Intensive Care Unit (NICU). ⋯ Health professionals use multidimensional indicators to assess neonatal pain. Nonpharmacological interventions dominate pain management. NI risk status and procedure invasiveness are important contextual factors in neonatal pain assessment and management.
-
In animals, decades of research have shown that serotonin (5-HT) is involved in endogenous pain inhibition systems, which are deficient in chronic pain disorders such as fibromyalgia (FM). In humans, there is preliminary evidence showing that 5-HT is involved in the FM pathophysiology. In the current endophenotyping study, we sought to investigate, for the first time in humans, the relationships between the serotonin transporter promoter region (5-HTTLPR) polymorphism and experimentally-induced pain perception/inhibition in healthy controls (HC) and FM patients. ⋯ Our results further confirm that FM is associated with thermal hyperalgesia and deficient DNIC. However, we found no evidence showing that the 5-HTTLPR polymorphism influences pain perception and DNIC. Potential reasons for this negative result will be discussed. Further endophenotyping studies of 5-HT-related gene polymorphisms are required to ascertain the potential relationships between 5-HT and human pain perception/inhibition.
-
Withdrawal from analgesic and addictive substances such as opioids or ethanol is associated with increased sensitivity to sensory stimulation in animal models. Here, we investigated perception of innocuous and noxious thermal or electric stimuli applied to the left hand or sternum in 30 male patients undergoing withdrawal from alcohol, 30 male abstained alcoholics and matched controls. The alcohol withdrawal scale and the Banger score were obtained to estimate the severity of withdrawal. ⋯ No differences were found between patients of the abstained group and control subjects for any pain parameter. In conclusion, we demonstrate withdrawal-induced hyperalgesia upon thermal stimulation in patients. Since the influence of affective symptoms on pain perception during withdrawal is remarkable, we assume that peripheral and central mechanisms might account for this finding, which should be assessed in detail in future studies.