Articles: pain-measurement.
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When the nerve tissue is injured, endogenous agonist of melanocortin type 4 (MC4) receptor, α-MSH, exerts tonic pronociceptive action in the central nervous system, contributing to sustaining the neuropathic pain state and counteracting the analgesic effects of exogenous opioids. With the intent of enhancing opioid analgesia in neuropathy by blocking the MC4 activation, so-called parent compounds (opioid agonist, MC4 antagonist) were joined together using various linkers to create novel bifunctional hybrid compounds. Analgesic action of four hybrids was tested after intrathecal (i.t.) administration in mouse models of acute and neuropathic pain (chronic constriction injury model, CCI). ⋯ Opioid receptor antagonists and MC4 receptor agonists diminished the analgesic action of these two hybrids studied, though the extent of this effect differed between the hybrids; this suggests that linker is of key importance here. Further results indicate a significant advantage of hybrid compounds over the physical mixture of individual pharmacophores in their analgesic effect. All this evidence justifies the idea of synthesizing a bifunctional opioid agonist-linker-MC4 antagonist compound, as such structure may bring important benefits in neuropathic pain treatment.
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To develop a culturally adapted and validated Bengali Pain Catastrophizing Scale (BePCS). ⋯ The interviewer-administered BePCS appears to be an acceptable, reliable and valid instrument for measuring health-related quality of life in Bengali speaking patients with chronic non-malignant musculoskeletal pain. Further evaluation in the general population and in different medical conditions should be done.
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Acute and chronic pain delay recovery and impair outcomes after major pediatric surgery. Understanding unique risk factors for acute and chronic pain is critical to developing effective treatments for youth at risk. We aimed to identify adolescent and family psychosocial predictors of acute and chronic postsurgical pain after major surgery in adolescents. ⋯ Tailored interventions need to be developed and incorporated into perioperative care to address risk factors for acute and chronic pain. PERSPECTIVE: Longitudinal results demonstrate adolescents' presurgery pain severity predicts acute postsurgical pain, while depressive symptoms and poor sleep quality predict chronic postsurgical pain. Tailored interventions should address separate risk factors for acute and chronic pain after adolescent surgery.
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Review Meta Analysis Comparative Study
Comparing central pain processing in individuals with non-traumatic neck pain and healthy individuals: a systematic review and meta-analysis.
This systematic review and meta-analysis examined the evidence for altered central pain processing in people with nontraumatic neck pain and the relationship among central pain processing, demographics, and pain-related characteristics. Case-control studies reporting measures of altered central pain processing using quantitative sensory testing were reviewed. Standardized mean differences (SMDs) and 95% confidence intervals between people with nontraumatic neck pain and controls were calculated. ⋯ This review suggests that altered central pain processing is present in people with nontraumatic neck pain and may be associated with disability levels and age. PERSPECTIVE: This review found moderate-quality evidence of mechanical hyperalgesia at remote nonpainful sites in patients with nontraumatic neck pain compared with controls, indicating altered central pain processing. However, more studies are needed to confirm findings from dynamic quantitative sensory testing.
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Randomized Controlled Trial
A Secondary Analysis from a Randomized Trial on the Effect of Plasma Tetrahydrocannabinol Levels on Pain Reduction in Painful Diabetic Peripheral Neuropathy.
This report examines the association between tetrahydrocannabinol (THC) plasma levels and pain response in a secondary analysis of data from a recent diabetic neuropathy study that demonstrated a dose-dependent reduction in spontaneous and elicited pain at specific time points. A randomized, double-blinded, placebo-controlled crossover study was conducted in sixteen patients with painful diabetic peripheral neuropathy. Subjects participated in four sessions, separated by 2 weeks, during each of which they were exposed to one of four conditions: placebo, or 1%, 4%, or 7% THC dose of cannabis. ⋯ Perspective: This analysis correlating plasma THC levels and pain reduction in diabetic neuropathy suggest a therapeutic window. Low and high THC levels had a negative association (no reduction) and THC levels within the window had a positive association (reduction). There was a minor negative linear effect of THC on cognitive function.