Journal of pain research
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Journal of pain research · Jan 2016
Novel method for assessing age-related differences in the temporal summation of pain.
Temporal summation (TS) of pain protocols typically involve the delivery of brief repetitive noxious stimuli held at a constant intensity and measuring the consequent increase in the perceived intensity of pain sensations. To date, no studies have examined the effect of a TS protocol on the perceived spatial dimensions of the pain experience and its interaction with age. This study used a new TS protocol that examined changes in the perceived size of the painful area in 22 younger adults and 20 older adults. ⋯ The results indicated that older adults compared to younger adults exhibited significantly greater summation of size ratings for the 2.5-second and 3.5-second IPI trials and size of pain aftersensations at 3 seconds following the 2.5-second IPI TS trial. These results suggest that aging is associated with enhanced endogenous facilitation of the perceived size of pain. The potential clinical and mechanistic implications of enhanced TS of size of pain remain unknown and warrant further investigation.
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Journal of pain research · Jan 2016
Endogenous inhibition of pain and spinal nociception in women with premenstrual dysphoric disorder.
Premenstrual dysphoric disorder (PMDD) is characterized by severe affective and physical symptoms, such as increased pain, during the late-luteal phase of the menstrual cycle. The mechanisms underlying hyperalgesia in women with PMDD have yet to be identified, and supraspinal pain modulation has yet to be examined in this population. The present study assessed endogenous pain inhibitory processing by examining conditioned pain modulation (CPM, a painful conditioning stimulus inhibiting pain evoked by a test stimulus at a distal body site) of pain and the nociceptive flexion reflex (NFR, a spinally-mediated withdrawal reflex) during the mid-follicular, ovulatory, and late-luteal phases of the menstrual cycle. ⋯ Endogenous modulation of pain and spinal nociception is not disrupted in women with PMDD. Additionally, greater NFR magnitudes during ovulation in PMDD may be due to tonically-engaged descending mechanisms that facilitate spinal nociception, leading to enhanced pain during the premenstrual phase.
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Journal of pain research · Jan 2016
ReviewOptions for perioperative pain management in neurosurgery.
Moderate-to-severe pain following neurosurgery is common but often does not get attention and is therefore underdiagnosed and undertreated. Compounding this problem is the traditional belief that neurosurgical pain is inconsequential and even dangerous to treat. Concerns about problematic effects associated with opioid analgesics such as nausea, vomiting, oversedation, and increased intracranial pressure secondary to elevated carbon dioxide tension from respiratory depression have often led to suboptimal postoperative analgesic strategies in caring for neurosurgical patients. ⋯ Postoperative pain control should be a priority, because pain adversely affects recovery and patient outcomes. Inconsistent practices and the quality of current analgesic strategies for neurosurgical patients still leave room for improvement. Given the complexity of postoperative pain management for these patients, multimodal strategies are often required to optimize pain control and at the same time limit undesired side effects.
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Journal of pain research · Jan 2016
Effects of low-dose ketamine on succinylcholine-induced postoperative myalgia in outpatient surgeries: a randomized, double-blind study.
Despite the many complications of succinylcholine, it is still widely used as a superior muscle relaxant for rapid sequence induction. One of these complications is postoperative myalgia (POM). The aim of this study was to investigate the prophylactic effect of low-dose ketamine on the incidence and severity of POM. ⋯ The addition of 0.5 mg/kg of ketamine to propofol for the induction of anesthesia can be effective in reducing the incidence of low-grade POM.
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Journal of pain research · Jan 2016
Dysesthesia symptoms produced by sensorimotor incongruence in healthy volunteers: an electroencephalogram study.
Pathological pain such as phantom limb pain is caused by sensorimotor incongruence. Several studies with healthy participants have clearly indicated that dysesthesia, which is similar to pathological pain, is caused by incongruence between proprioception and/or motor intention and visual feedback. It is not clear to what extent dysesthesia may be caused by incongruence between motor intention and visual feedback or by incongruence between proprioception and visual feedback. The aim of this study was to clarify the neurophysiology of these factors by analyzing electroencephalograms (EEGs). ⋯ The present findings suggest that neural mechanisms of dysesthesia are caused by incongruence between proprioception associated with motor intention and visual feedback and, in particular, are a result of incongruence between proprioception only and visual feedback.