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PubMed2006

Musically induced arousal affects pain perception in females but not in males: a psychophysiological examination.

The present study investigated affective and physiological responses to changes of tempo and mode in classical music and their effects on heat pain perception. Thirty-eight healthy non-musicians (17 female) listened to sequences of 24 music stimuli which were variations of 4 pieces of classical music. Tempo (46, 60, and 95 beats/min) and mode (major and minor) were manipulated digitally, all other musical elements were held constant. Participants rated valence, arousal, happiness and sadness of the musical stimuli as well as the intensity and the unpleasantness of heat pain stimuli which were applied during music listening. Heart rate, respiratory rate and end-tidal PCO(2) were recorded. Pain ratings were highest for the fastest tempo. Also, participants' arousal ratings, their respiratory rate and heart rate were accelerated by the fastest tempo. The modulation of pain perception by the tempo of music seems to be mediated by the listener's arousal.

Adolescent↗
PubMed1991

[Pain perception during simulated static work].

The purpose of this study was to determine the effect of current design recommendations (additional rest allowances) for static work on the development of temporary musculo-skeletal pains. The subjects were healthy, relatively fit young adults (16 men). Static work at 25% MVC was performed both in a commonly-used working posture and in a nontypical posture (overhead work). The ratios of work-to-rest corresponded to the ergonomical recommendations. Estimates of pain-perceptions concerning the neck, shoulders and back/trunk were recorded during the muscular exercise. The results show that under certain conditions (commonly-used working posture) the additional rest allowances render possible an exercise without musculoskeletal pains. During overhead work the development of temporary pain-perceptions is not inhibited by additional rest allowances. A revision of the current design recommendations for overhead work is suggested.

Adult↗
PubMed2002

Pain perception in the older patient. Using the pain hologram to understand neck and shoulder pain.

Pain is a common complaint and its perception is a complex issue. The older person with neck and shoulder pain may have contributions to that pain from multiple and diverse sources. These can range from nociceptive stimulation, neurologic sensitization, emotional issues, socio-cultural biases, cognitive interpretation and meanings of the pain to that person, concurrent medical and psychiatric illnesses, and memory (both pain and non-pain related memories). The affective dimension of pain can be more influential on a person's ultimate pain experience than the sensory-discriminative component, and both must be understood for each patient, in terms of it's relative weight in each pain. Neck and shoulder pain can represent eudynia and maldynia, or concurrent existence of both. To properly treat patients with this complaint, physicians must understand what comprises each individual's pain hologram and direct treatment at as many component parts as possible.

Aged↗
PubMed1998

Current concepts in the pathophysiology of abnormal pain perception in fibromyalgia.

Fibromyalgia is a noninflammatory rheumatic disorder characterized by chronic widespread musculoskeletal pain. Although many studies have described the pain and other clinical symptoms associated with this disorder, the primary mechanisms underlying the etiology of fibromyalgia remain elusive. This article reviews recent data supporting the links among each of three systems--the musculoskeletal system, the neuroendocrine system, and the central nervous system (CNS), all of which appear to play major roles in fibromyalgia pathophysiology--and pain in fibromyalgia, and concludes by presenting a model of the pathophysiology of abnormal pain perception in fibromyalgia which integrates the research findings described.

Central Nervous System↗
PubMed1995

Sedation with intravenous infusions of propofol or thiopentone. Effects on pain perception.

The aim of this study was to investigate pain perception during thiopentone or propofol infusions for sedation. Thirty ASA 1 or 2 patients received a two step infusion of either thiopentone (step 1: 1.25 mg.kg-1 followed by 2.5 mg.kg-1.h-1; step 2: 1.25 mg.kg-1 and 12.5 mg.kg-1.h-1; n = 15) or propofol (step 1: 0.5 mg.kg-1, 1 mg.kg-1.h-1; step 2: 0.5 mg.kg-1, 5 mg.kg-1.h-1; n = 15) for sedation. At control and 10 min after the start of each infusion dosage, reaction times and thermal pain detection thresholds were determined. We found no clinically or statistically significant depression of thermal pain detection thresholds during propofol or thiopentone infusions and these are, therefore, unlikely to be associated with clinically relevant hyperalgesia.

Adolescent↗
PubMedDate not supplied

A preliminary study on pain perception and tobacco smoking.

Ischaemic pain onset and tolerance in response to a pneumatic blood pressure cuff were compared in 17 non-deprived smokers, 30 deprived smokers, 15 smokers chewing nicotine gum and 16 non-smokers. Following removal of the cuff, all subjects completed the McGill pain questionnaire, rating pain in terms of its sensory, affective, evaluative and miscellaneous qualities. Group differences were found in the time elapsing before reporting the first twinge of pain. Non-deprived smokers had the shortest period to onset of pain. The longer the smokers had been deprived of cigarettes, the longer before the onset of pain. Non-deprived smokers also had a significantly shorter period of pain tolerance compared to deprived smokers. Non-deprived smokers tended to have a faster pain onset and a shorter tolerance period compared to non-smokers. Smokers' indices of pain were significantly higher on the several sub-scales describing the qualitative pain experience compared to non-smokers and to smokers deprived of cigarettes for more than one hour. Deprivation of cigarettes appears to diminish smokers' sensitivity to pain significantly below that of non-smokers and smoking cigarettes tends to heighten sensitivity to, or beyond, the level of non-smokers.

Adolescent↗
PubMed1988

Effect of hyperglycemia on pain perception and on efficacy of morphine analgesia in rats.

The effect exerted by different hyperglycemic states on the pain threshold and on the analgesic potential of morphine was studied in male Sabra rats with the hot plate device. Hyperglycemia induced by an intraperitoneal injection of 0.014 mol/kg glucose or an acute or chronic diabetic state induced by streptozocin injection did not significantly alter the pain threshold. However, states of acute and chronic diabetes markedly blunted the analgesic effect of morphine (5 mg/kg). Sabra rats maintained on a cocktail of glucose-saccharin, thought to activate the release of endogenous opioids, demonstrated an increased pain threshold and rapidly developed resistance to the analgesic effect of morphine. Previous studies have shown that glucose in high concentration may interfere with the interaction of morphine on the opiate receptor. The influence of the diabetic state on beta-endorphin synthesis and concentration in the central nervous system is another factor that might change pain perception in diabetes. We propose that in diabetes, generally, the pain threshold is adequately maintained, despite the antagonistic effect of glucose, partly due to a compensatory increased secretion of endogenous opioid peptides. We hypothesize that in patients with chronic painful diabetic neuropathy, these normal analgesic response mechanisms may be overwhelmed either by an excess of nociceptive impulses from diseased peripheral nerves or conceivably by a failure of endogenous opioid secretory response to the hyperglycemia.

Action Potentials↗
PubMed2006

TREK-1, a K+ channel involved in polymodal pain perception.

The TREK-1 channel is a temperature-sensitive, osmosensitive and mechano-gated K+ channel with a regulation by Gs and Gq coupled receptors. This paper demonstrates that TREK-1 qualifies as one of the molecular sensors involved in pain perception. TREK-1 is highly expressed in small sensory neurons, is present in both peptidergic and nonpeptidergic neurons and is extensively colocalized with TRPV1, the capsaicin-activated nonselective ion channel. Mice with a disrupted TREK-1 gene are more sensitive to painful heat sensations near the threshold between anoxious warmth and painful heat. This phenotype is associated with the primary sensory neuron, as polymodal C-fibers were found to be more sensitive to heat in single fiber experiments. Knockout animals are more sensitive to low threshold mechanical stimuli and display an increased thermal and mechanical hyperalgesia in conditions of inflammation. They display a largely decreased pain response induced by osmotic changes particularly in prostaglandin E2-sensitized animals. TREK-1 appears as an important ion channel for polymodal pain perception and as an attractive target for the development of new analgesics.

Animals↗
PubMed2004

The effect of breathing and skin stimulation techniques on labour pain perception of Turkish women.

OBJECTIVE: To determine the effect of breathing techniques and nurse-administered massage on the pain perception of pregnant woman during labour. SETTING AND PARTICIPANTS: The present study was conducted among pregnant women (75% primiparous) admitted to the SSK Bakirkoy Women and Children's Hospital (Istanbul, Turkey) between January 1, and September 1, 2000. The patients were in their 38th to 42nd week of pregnancy, not at high risk and expected to have normal vaginal delivery. They were selected from volunteers by nonrandom sampling. STUDY DESIGN: The present study involved 40 cases, with 20 in the experimental group and 20 in the control group. Data were obtained through the visual analogue scale, inspection form, observation form and postnatal interview form. The study investigators provided information about labour, breathing techniques and massage to the pregnant women assigned to the experimental group at the beginning of labour (latent phase). A study investigator also accompanied them during labour. These women received nurse-administered massage and were encouraged to breathe and perform self-administered massage. They were also instructed to change their positions and to relax. RESULTS AND CONCLUSION: Study results demonstrated that nursing support and patient-directed education concerning labour and nonpharmacological pain control methods (eg, breathing and cutaneous stimulation techniques) were effective in reducing the perception of pain by pregnant women (when provided in the latent labour phase before delivery), leading to a more satisfactory birth experience.

Adaptation, Psychological↗
PubMed2004

Mental stress inhibits pain perception and heart rate variability but not a nociceptive withdrawal reflex.

AIM: Do distraction from- or attention to sural nerve stimulation affect pain, heart rate variability, and a spinal withdrawal reflex? MATERIAL AND METHODS: In 26 male volunteers, electrical stimulation at the distal cutaneous receptive field of the sural nerve elicited pain and a nociceptive withdrawal reflex. Intensity of pain was rated on a numeric rating scale. Electromyographic reflex responses were measured from biceps femoris muscle. Cardiac autonomic function was estimated by heart rate variability measures and was expressed in the time domain as mean of RR-intervals for normal heart beats (mean-RR) and standard deviation of all normal RR-intervals (SD-NN) and, in the frequency domain, where pure vagal activity was assessed by high frequency power (0.15-0.4 Hz). Low frequency power (0.04-0.15 Hz) reflects both parasympathetic and sympathetic control. Effect parameters were recorded before and during random distraction and attention. Distraction from sural nerve stimulation was induced by a mental arithmetic test, paced auditory serial addition task (PASAT), while attention was induced by concentrating on painful foot stimulation. RESULTS: Paced auditory serial addition task decreased mean-RR and SD-NN, frequency domain parameters, as well as pain (P<0.001). In contrast, PASAT did not change the spinal withdrawal reflex. Attention did not affect any effect parameter. CONCLUSION: Distraction by PASAT altered autonomic activity and inhibited pain but failed to affect withdrawal reflex responses, while attention had no effect on either parameter. Psychological distraction and attention may have different effects on noxious evoked pain perception and autonomic activity. Pain relief during PASAT probably involves supraspinal mechanisms.

Adult↗
PubMed1992

Pain perception and effectiveness of the eutectic mixture of local anesthetics in children undergoing venipuncture.

The emulsion of lidocaine and prilocaine (EMLA) is effective in preventing the pain of venipuncture in children. It is therefore important to identify children who could benefit the most from EMLA. We studied the safety and feasibility of two methods of application of EMLA (patch and cream) in a randomized, open-label trial of EMLA patch versus EMLA cream in 160 children with chronic diseases undergoing venipuncture. EMLA patch or cream was applied 60 to 120 min before puncture. Pain was assessed by the children using a visual analogue score. Children also scored the pain of their last puncture and the pain of removing the tape. EMLA patch and cream had similar efficacy (visual analogue scores for the venipuncture were 8.5 +/- 16 and 9.5 +/- 17 out of 100, respectively). Side effects occurred in similar frequencies in the two groups. Adhesiveness of the patch was less effective than that of the cream with Tegaderm. Age was a major determinant of pain perception; younger children recalled more severe pain in their previous puncture. Children recently diagnosed had higher visual analogue scores than those with a long history of chronic disease. We concluded that EMLA patch and cream have a similar efficacy in children undergoing venipuncture. Young children recently diagnosed with chronic disease are most likely to benefit from EMLA.

Adolescent↗
PubMed2001

Major roles of prostanoid receptors IP and EP(3) in endotoxin-induced enhancement of pain perception.

To know the roles of prostaglandin I (IP) and prostaglandin E (EP) receptors in pain perception, we compared the acetic acid-induced writhing response in mice deficient in prostaglandin receptors, i.e. IP, EP(1,) EP(2,) EP(3,) or EP(4,) with or without lipopolysaccharide (LPS) pretreatment. Without LPS pretreatment, IP-receptor deficient mice showed a significantly smaller number of responses, as previously reported, whereas mice deficient in any of the EP-receptor subtypes showed a number of writhings similar to those of wild-type mice. When mice were pretreated with LPS for 24 hr to induce cyclooxygenase-2 expression, the wild-type as well as EP(1)-, EP(2)-, or EP(4)-receptor-deficient mice showed a similar enhanced writhing response, whereas IP- and EP(3)-receptor-deficient mice had a significantly less enhanced number of writhings. These results indicate that IP and EP(3) are the major prostaglandin receptors mediating the enhanced acetic acid-induced writhing response in mice pre-exposed to LPS, i.e. in endotoxin-enhanced inflammatory nociception.

Animals↗
PubMed1998

Treatment with enalapril modifies the pain perception pattern in hypertensive patients.

The cardiovascular system shares numerous anatomic and functional pathways with the antinociceptive network. The aim of this study was to investigate whether angiotensin-converting enzyme (ACE) inhibitor treatment could affect hypertension-related hypalgesia. Twenty-five untreated hypertensive patients, together with a control group of 14 normotensive subjects, underwent dental pain perception evaluation by means of a pulpar test (graded increase of test current applied to healthy teeth). After the evaluation of the dental pain threshold (occurrence of pulp sensation) and tolerance (time when the subjects asked for the test to be stopped), all the subjects underwent a 24-hour ambulatory blood pressure monitoring. The hypertensive group then was treated with 20 mg/d enalapril, whereas the normotensive subjects remained without any treatment. After a time interval of 6+/-2 months, the dental pain sensitivity was retested in all the subjects, and ambulatory blood pressure was recorded during treatment in the hypertensive patients. At the first assessment, hypertensive patients showed a higher pain threshold than normotensive subjects (P<.001). On retesting of pain sensitivity in hypertensive patients, a significant decrease of both pain threshold and tolerance, leading to their normalization, was observed during treatment (P<.001 and P<.005, respectively), in the presence of reduced 24-hour and office blood pressure values. A slight, though significant, correlation was observed between variations in pain tolerance and baseline blood pressure changes occurring during treatment. During follow-up, the normotensive subjects did not show any significant pain perception or office blood pressure changes. Hypertension-related hypalgesia was confirmed. Mechanisms acting both through lowering of blood pressure and specific pharmacodynamic properties may account for the normalization of pain sensitivity observed in hypertensive patients during treatment with ACE inhibitors.

Adult↗
PubMed1990

Effect of ketanserin on pain perception in arterial hypertension.

An association between increased tolerance to pain and arterial hypertension has been reported in experimental animals and confirmed in humans. The underlying mechanisms remain elusive. We have recently reported that diuretics and beta-blocking treatment do not influence pain sensitivity, despite significant reductions in arterial blood pressure. In the present study, ketanserin was evaluated. As in previous work, pain perception was assessed with a tooth pulp tester. Ten hypertensive subjects were studied basally, after 15 days and after 3 months of ketanserin treatment (20 mg twice daily). Significant reductions in arterial blood pressure and of pain thresholds were observed, but no correlation between these changes occurred. These preliminary data indicate that, contrary to other hypotensive drugs, ketanserin tends to decrease or reverse the abnormality in pain modulation observed in hypertensive patients. The lack of a correlation between effects on blood pressure and pain sensitivity seems, however, to favor the hypothesis of two independent underlying mechanisms.

Adult↗
PubMed1991

[The role of beta-endorphin and pain perception in silent myocardial ischemia].

Plasma beta-endorphin (beta-END) levels were measured before, after exercise tests and at the onset of spontaneous angina in 23 anginal patients (group 1), 23 patients with silent myocardial ischemia (group 2) and 15 healthy volunteers (group 3). The pain perception in three groups was also measured. Before and after exercise, the concentration of beta-END in group 1 was significantly lower than that in group 2 and group 3. The concentration of beta-END during onset of spontaneous angina was also lower than that of angina-free period in group 1. There was no significant difference of beta-END between group 2 and 3. The values of the pain threshold and tolerance in group 1 were lower than those of group 2 and 3. These data suggested that plasma levels of beta-END may be related to occurrence of angina. The anginal patients had a hypersensitivity and hypotolerance for pain. A positive correlation was found between plasma beta-END and pain threshold, the levels of beta-END might affect the pain perception during the onset of myocardial ischemia.

Angina Pectoris↗
PubMed1981

Developing concept of the gating mechanisms in pain perception.

A short review of the main trends in neurophysiological research of the gating mechanism of pain perception is presented. The original model of Melzack and Wall has been modified in two aspects. First - postsynaptic inhibition and increased concentration of potassium ions in the extracellular space play a role in the modulation of impulse transmission at the segmental level of the spinal cord. Second - serotoninergic descending pathways originating in the medial structures of the brain stem which are very sensitive to narcotics contribute to the modulation of synaptic transmission from nociceptors.

Humans↗