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Results for “Pain Perception”

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At least 379 records · Page 21Linked to original sources
PubMed2006

Randomized comparison of pain perception during radial head subluxation reduction using supination-flexion or forced pronation.

OBJECTIVE: To determine if a difference exists in perceived pain between the forced pronation and supination-flexion methods of radial head subluxation (RHS) reduction. DESIGN AND METHODS: We developed a prospective randomized trial of children aged 6 months to 7 years who presented to the emergency department (ED) at Miami Children's Hospital with an immobile arm and physical findings suggestive of RHS. Children were randomized into 2 groups for RHS reduction: forced pronation and supination-flexion. Parents, physicians, and nurses were given a standard visual analog pain scale for pain assessment before, during, and at 1 minute after successful reduction. RESULTS: Seventy-five children presented to the ED with RHS; 3 children were excluded from the study because of nonadherence to the protocol and another 9 were excluded because of unsuccessful reduction during the first attempt. Of the remaining children, 32 children underwent forced pronation and 31 underwent supination-flexion. Physicians did not find a significant difference in gain scores between their perceptions of the premeasure and postmeasure of pain between those patients receiving supination-flexion and those receiving forced pronation. For nurses (P < 0.031) and parents (P < 0.043), there were statistically significant differences in gain scores. Nurses and parents perceived forced pronation as being less painful. The mean difference for parents was 1.7 cm, which exceeded the value of 1.3 cm identified as clinically significant. CONCLUSIONS: Forced pronation is perceived as less painful than the supination-flexion method by parents of children treated for RHS in our ED.

Arm Injuries↗
PubMed2000

Lumbar sympathetic block for sympathetically maintained pain: changes in cutaneous temperatures and pain perception.

UNLABELLED: Lumbar sympathetic block (LSB) is used in the management of sympathetically maintained pain states. We characterized cutaneous temperature changes over the lower extremities after LSB. Additionally, we examined the effects of iohexol, a radio-opaque contrast medium, on temperature changes and pain relief. After institutional review board approval and written, informed consent, 28 LSBs were studied in 17 patients. Iohexol or normal saline was injected in a randomized, double-blinded fashion before bupivacaine. Lower extremity cutaneous temperatures were measured. Pain, allodynia, interference with daily function, and perceived pain relief were reported in a subset of 15 LSBs for 1 wk after the block. The distal lower extremity ipsilateral to the LSB had the greatest magnitude (8.7 degrees +/- 0.8 degrees C) and rate (1.1 degrees +/- 0.2 degrees C/min) of temperature change. The great toe temperature was within 3 degrees C of core temperature within 35 min after LSB. There were no differences in temperature change between the groups. The iohexol group had greater relief of pain until the morning of the first postblock day (P = 0.002) and longer perceived relief of pain (P = 0.01). The maximum temperature of the great toe correlated with allodynia relief (P = 0.0007). Thus clinicians should expect ipsilateral toe temperatures to increase to within approximately 3 degrees C of core temperature. Iohexol does not alter the efficacy of LSB and may improve relief of symptoms. The magnitude of temperature change may predict relief of allodynia. IMPLICATIONS: Cutaneous toe temperatures approaching core temperature provide a useful monitor of lumbar sympathetic block and may predict relief of sympathetically maintained pain. Iohexol will not compromise temperature changes or pain relief.

Adult↗
PubMedDate not supplied

Pain perception in depression: relationships to symptomatology and naloxone-sensitive mechanisms.

A decrease in pain sensitivity during acute depression has been observed in several studies, apparently related to the severity of symptomatology. However, the question remains whether this relationship can be found only in heterogeneous groups of depressive patients or also in a single diagnostic group, such as major depression. In the present study, pain thresholds were assessed in 20 patients with major depression (DSM-III-R) and in 20 healthy controls. Two threshold methods with a differing impact of reaction time on the results were used. Contact heat was applied as a natural source of pain. With both methods the pain thresholds were significantly increased in the depressive patients. No relationship was found to the various symptoms of depression assessed by psychopathometric scales. In contrast to the pain thresholds, the thresholds of skin sensitivity for nonnoxious stimuli (warmth, cold, vibration) were only slightly increased. In subsamples (N = 10 in each group), naloxone (5 mg i.v.) and placebo were administered in a double-blind design. No systematic changes in pain thresholds occurred under either treatment. Our findings suggest that the decrease in skin sensitivity in major depression is specific to pain and not due to an increased reaction time. Moreover, the decrease appears to be related neither to a naloxone-sensitive mechanism nor to symptomatology.

Adult↗
PubMed1989

Pain perception in a man with total corpus callosum transection.

While classical and current theories of pain emphasize the critical role of central neural pathways that represent the contralateral body surface and cross within the spinal cord, the role of neural input representing the ipsilateral body surface is uncertain. In the present experiments with a complete corpus callosum-sectioned patient, both tactile and low intensity noxious stimuli (43-47 degrees C) ipsilateral to the responding cerebral hemisphere were poorly perceived and/or rated low on verbal and visual analogue scales (VAS). Surprisingly, however, high intensity noxious thermal stimuli (49-51 degrees C) were rated on verbal or visual analogue scales as very intense and unpleasant, thereby reflecting both sensory-discriminative and motivational-affective dimensions of pain. Thus, the pathways and mechanisms subserving this ipsilateral input have high thresholds for activation, but once activated are sufficient to evoke all of the critical dimensions of the experience of pain.

Adult↗
PubMed1989

The utility of cognitive coping strategies for altering pain perception: a meta-analysis.

The literature on the utility of cognitive coping strategies in pain control has been unclear because of 2 principal limitations: the lack of a validated classification system, and reliance on qualitative and quasi-statistical reviews. In this study, an empirically based multidimensional taxonomy was employed to categorize the variety of cognitive coping strategies into 6 major classes: external focus of attention, neutral imaginings, pleasant imaginings, dramatized coping, rhythmic cognitive activity and pain acknowledging. Meta-analytic techniques were introduced to evaluate the overall efficacy of cognitive strategies (in comparison to no-treatment controls), the relative efficacy of these strategies (how the different groups of strategies compare with one another), and the substantive efficacy of such strategies (how cognitive strategies fare against placebo/expectancy conditions). Results revealed that, in general, cognitive coping strategies are more effective in alleviating pain as compared to either no-treatment or expectancy controls. Each individual class of strategies significantly attenuates pain although the imagery methods are the most effective whereas pain acknowledging is the least effective. Positive expectancy is no better than no treatment. These findings stand in contrast with previous reviews that have not assigned prime importance to imagery or for that matter have not shown cognitive strategies to be particularly effective. Results are discussed with reference to attentional models and methodological issues.

Adaptation, Psychological↗
PubMed2004

Pain perceptions of the oldest old: a longitudinal study.

PURPOSE: This study assessed self-reported pain in the oldest old and examined its changes over time and in relation to other measures of health and functioning. DESIGN AND METHODS: A population-based sample of the oldest old (86-92 years of age) residing in Sweden who were participating in a multiwave longitudinal investigation were interviewed about their experience of pain, as well as other dimensions of health and functioning. RESULTS: Prevalence of pain at baseline was 34% and rose to 40% at follow-up. Incidence of new pain cases during that period was 16 percent. Pain was significantly related to sleep difficulties, medication usage, global subjective health, depressive symptoms, and mobility, though the magnitude of the associations was relatively small. IMPLICATIONS: Our results extend previous cross-sectional findings by demonstrating there is both an increase in the proportion of people reporting pain over time after the age of 85 as well as the possibility of recovery. The modest strength of associations of pain with other areas of functioning suggests adaptation and selectivity among survivors in very late life.

Aged↗
PubMed2005

Pain perception in irritable bowel syndrome.

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by chronic abdominal discomfort or pain in the absence of detectable organic disease. IBS is common and is associated with a significant impairment in health-related quality of life. Enhanced perception of visceral stimuli ("visceral hypersensitivity") appears to be an important pathophysiological mechanism. Early IBS studies using functional brain imaging techniques suggest an alteration in central pain modulation circuits, rather than an increased sensitivity of peripheral visceral pain pathways. The frequent comorbidity with psychiatric disorders suggests the possibility of shared pathophysiological mechanisms and etiologic factors.

Comorbidity↗
PubMed1996

Pain perception and cardiovascular responses in men with positive parental history for hypertension.

Evidence suggests a reduced pain sensitivity in hypertensive individuals. This study sought to extend this work to normotensive individuals with hypertensive parents. Men with a positive (PH+) or negative (PH-) parental history for hypertension rated their pain every 15 s during a 90-s hand cold pressor test and for 90 s after the cold pressor test. Systolic (SBP) and diastolic (DBP) blood pressures and heart rate were measured throughout. After the cold pressor test, the men recalled their pain using the McGill Pain Questionnaire. PH+ men showed greater SBP and DBP responses to the cold pressor test. Although pain ratings during the cold pressor test did not differ between groups, posttest reported pain receded faster in the PH+ than in the PH- men. The PH+ men also reported less total pain on the McGill. These findings support the hypothesis that risk for hypertension may be associated with attenuated pain responses to nociceptive stimuli.

Adult↗