European journal of pain : EJP
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Comparative Study Controlled Clinical Trial
Effects of untreated preoperative essential hypertension on post-operative pain after major abdominal surgery.
Hypertension has been associated with hypoalgesia. This prospective study was designed to test the effects of untreated preoperative essential hypertension on post-operative pain intensity and morphine requirement after major abdominal surgery. ⋯ Untreated essential hypertension is associated with significantly reduced post-operative morphine requirement and pain intensity, suggesting hypertension-associated hypoalgesia.
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Comparative Study
Pain tolerance in children and adolescents: sex differences and psychosocial influences on pain threshold and endurance.
Laboratory studies with children and adolescents revealed inconsistent findings regarding sex differences in pain tolerance, although lower pain tolerance is commonly reported for adult women. Besides biological mechanisms, several socio-cognitive variables are discussed which may influence pain tolerance in regard to sex differences. The purpose of the present study was to investigate the pain tolerance of children and adolescents using the cold pressor task (CPT) and to analyse influences of pain-coping and pain-related self-efficacy. ⋯ Our results support the assumption that female and male adolescents develop in different directions regarding their pain tolerance when reaching puberty. This seems mainly attributable to a decrease of pain threshold in girls. In contrast, boys and girls are able to endure pain to an equal extent influenced, however, by self-efficacy and coping variables.
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The aim of this study was to determine if genetic variation in the pain-modulating gene DREAM and its pathway genes influence susceptibility to reporting musculoskeletal pain in the population. ⋯ Genetic variation in the DREAM pathway genes was associated with the extent of pain reporting in a population-based cohort. These findings were not replicated in a single independent cohort; however, given the potential of this pathway as a therapeutic target, further investigation in additional cohorts is warranted.
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Temporal summation of second pain (TSSP) is relevant for the study of central sensitization, and refers to increased pain evoked by repetitive stimuli at a constant intensity. While the literature reports on participants whose pain ratings increase with successive stimuli, response to a TSSP protocol can be variable. The aim of this study was to characterize the full range of responses to a TSSP protocol in pain-free adults. ⋯ Using a fixed thermal paradigm, pain-free adults exhibit substantial variability in response to a TSSP protocol not well characterized by group-mean slopes. Studies are needed to determine TSSP response patterns in clinical samples, identify predictors of response and determine the clinical implications of response variability.
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Over 1.4 million Caesarean deliveries are performed annually in the United States, out of which 30% are elective repeat procedures. Post-operative hyperalgesia is associated with an increased risk for persistent post-surgical pain; however, there are no data on whether residual scar hyperalgesia (SHA) from a previous Caesarean delivery (CD) persists until the next delivery. We hypothesized that residual SHA may be present in a substantial proportion of women and is associated with increased post-operative pain. ⋯ Preoperative SHA is present in 41% of women scheduled for repeat CD and is associated with increased mTS and post-operative pain. Screening for preoperative SHA may predict women at risk for increased post-operative pain, and guide post-operative analgesia to include anti-hyperalgesic drugs.