PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Pain Perception”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 577 records · Page 32Linked to original sources
PubMed1999

Assessing surgical patients' expectations and subsequent perceptions of pain in the context of exploring the effects of preparatory information: raising issues of gender and status.

The present study explored both patients' expectations and experiences of pain in the context of utilizing an established research procedure, which previously reported a significant effect of instructional information on post-surgical recovery. No research to date has systematically attempted to identify pre-operative expectations of post-operative pain, nor has it compared pre- and post-operative ratings. A further variable scrutinized during the study was patient gender.Thirty-two males and 31 females undergoing two types of elective surgery were randomly allocated into experimental and control conditions by a third party. Patients in the experimental group received additional instruction information pre-operatively from the anaesthetist and the control group received the routine pre-operative visit. Using a numerical pain scale, all participants provided ratings of expected pain levels and subsequently rated their pain following surgery.Results obtained were contrary to expectations with respect to the effects observed by the established study as instructional information had no significant effect on recovery variables. However, the study did suggest that pre- and post-operative pain ratings were broadly equivalent. A significant gender difference was also found with male patients expecting less pain than they perceived and an opposite pattern for females. Measuring both pain expectations and perceptions is considered a useful technique to inform pain management and is worthy of further investigation. The inconsistent effect of instructional information and the gendered rating patterns are considered in relation to gender and status differentials between health providers and have important implications for future research. Copyright 1999 European Federation of Chapters of the International Association for the Study of Pain.

Journal Article↗
PubMed2005

Fear of pain, not pain catastrophizing, predicts acute pain intensity, but neither factor predicts tolerance or blood pressure reactivity: an experimental investigation in pain-free individuals.

Previous studies of the Fear-Avoidance Model of Exaggerated Pain Perception have commonly included patients with chronic low back pain, making it difficult to determine which psychological factors led to the development of an "exaggerated pain perception". This study investigated the validity of the Fear-Avoidance Model of Exaggerated Pain Perception by considering the influence of fear of pain and pain catastrophizing on acute pain perception, after considering sex and anxiety. Thirty-two males and 34 females completed the State-Trait Anxiety Inventory, the Fear of Pain Questionnaire, and the Coping Strategies Questionnaire. Subjects underwent a cold pressor procedure and tolerance, pain intensity, and blood pressure reactivity were measured. Sex, anxiety, fear of pain, and pain catastrophizing were simultaneously entered into separate multiple regression models to predict different components of pain perception. Tolerance was not predicted by fear of pain, pain catastrophizing, or anxiety. Pain intensity at threshold and tolerance were significantly predicted by fear of pain, only. Blood pressure reactivity to pain was significantly predicted by anxiety, only. These results suggest that fear of pain may have a stronger influence on acute pain intensity when compared to pain catastrophizing, while neither of the factors predicted tolerance or blood pressure reactivity.

Acute Disease↗
PubMed1984

The relationship between strategies of coping and perception of pain in three chronic pain groups.

Examined the relationship between perception of pain, personality, coping and the reactions of family members in three chronic pain groups (sickle cell anemia, arthritis, and low back pain). Sixty black Ss equally distributed in the three medically diagnosed pain groups completed the McGill Pain Questionnaire, Maudsley Personality Inventory, a self-control measure, and the modified spouse response questionnaire. Nonsignificant association was detected between measures of pain and neuroticism; a significant inverse relationship was found between self-controlling behaviors and the affective dimension of pain; the relationship between perceived solicitous behavior and intensity and quality of pain differentiated the sickle cell and arthritic groups from the low back pain group; for the low back pain group, intensity of pain was related significantly to solicitous behaviors of family members, but the reverse was true for the arthritic and sickle cell groups.

Adaptation, Psychological↗
PubMed1983

Therapists' and chronic pain patients' perceptions of treatment outcome.

Pain is a complex phenomenon which is influenced by multiple factors; likewise, assessment of chronic pain patients' response to treatment is influenced by many variables. A physician, psychologist, physical therapist, and occupational therapist rated the extent of recovery of 40 chronic pain patients who had spent 4 to 6 weeks in an inpatient chronic pain treatment program. Each patient also rated his/her own degree of improvement. In addition, therapists and patients reported which factors were the primary determinants of their outcome ratings. Although therapists rated the patients as significantly more improved than the patients rated themselves, there was still a high degree of similarity between therapists' and patients' view of recovery. Therapists and patients were in high agreement concerning which patients were classified as treatment successes or failures. Furthermore, activity level and ability to cope with pain were frequently endorsed by therapists and patients as important determinants of recovery rating. Contrary to a previous report, the results of this study suggest that pain patients are not necessarily poor judges of (their own) treatment results. Perhaps more importantly, this study supports the use of a broad-based multidimensional approach to assessing treatment outcome for chronic pain patients.

Adult↗
PubMedDate not supplied

[Postoperative pain control in the Trento community hospital. Perception of pain by the nurses].

The College of Nurses of Trento (Collegio IPASVI) promoted a call for research works done by nurses, to award a prize to those judged worthy. The three best works were respectively on concordance on triage classification between doctors and nurses; on the results of organizational and educational interventions on the reduction of needle-stick injuries; and on the differences on postoperative pain assessment between nurses and patients. The final reports were later discussed as part of a training exercise aiming at improving the skill of scientific writing and they are published here, together with some comments that emphasize areas of improvement in data analysis and interpretation and some broader issues related to nursing research.

Analgesia↗
PubMed1979

Perception of pain to three different intraoral penetrations of needles.

There are no significant differences in perception of pain produced by penetrations of 25-, 27-, and 30-gauge needles in the retromolar fossa. Six dentists received three series of six needle penetrations, three in each retromolar fossa, at one-week intervals. The penetrations were made to a depth of 2 to 3 mm with use of a rapid in-and-out motion by 25-, 27-, and 30-gauge needles in an alternating sequence. The perception of pain for each penetration was recorded, tabulated, and statistically analyzed. There were no significant differences in the perception of pain elicited from the use of the three needles.

Adult↗
PubMed2003

Functional imaging and pain: behavior, perception, and modulation.

Time-dependent increases of local metabolic or blood flow rates have been described in spinal cord and brain during acute and chronic pain states in experimental animals, in parallel with changes of different behavioral endpoints of pain and hyperalgesia. In healthy human volunteers, pain intensity-related hemodynamic changes have been identified in a widespread, bilateral brain system including parietal, insular, cingulate, and frontal cortical areas, as well as thalamus, amygdala, and midbrain. Specific patterns of activity may characterize hyperalgesic states and some chronic pain conditions. Forebrain nociceptive systems are under inhibitory control by endogenous opioids and can be affected by acute administration of mu-opioid receptor agonists. Anticipation of pain may in itself induce changes in brain nociceptive networks. Moreover, pain-related cortical activity can be modulated by hypnotic suggestions, focusing or diverting attention, and placebo. These findings begin to disclose the spatio-temporal dynamics of brain networks underlying pain perception and modulation.

Animals↗
PubMed1991

Blood pressure reactivity and perception of pain during the forehead cold pressor test.

The relationship between blood pressure reactivity and the perception of pain was examined during a series of three forehead cold pressor tests given every other day to a group of 18 male college students. Subjects classified as high reactors on the basis of peak increases in mean blood pressure during cold pressor tests perceived the cold pressor stimulus as more painful than subjects classified as low reactors. The propensity to rate the cold pressor stimulus as painful was positively correlated with the individual level of blood pressure reactivity (baseline-free partial r = .62). Intra-individual correlations between pain and blood pressure responses were unrelated to subjects' reactivity status. Across the 3-min test, correlations between pain and blood pressure reactivity (with the effects of baseline blood pressure levels partialled out) were significant only during periods when levels of responses were relatively high. The heart rate responses were unrelated to pain ratings. Generalizability theory was applied to the analysis of temporal stability of cold pressor reactions. Both blood pressure and pain responses were highly reproducible across three sessions, appearing to express stable individual differences. The efficacy of 800 mg oral ibuprofen in controlling the cold pressor pain was also tested. Analgesic activity of the drug during the cold pressor test could not be demonstrated.

Adolescent↗
PubMed2004

Onset of pain relief with rofecoxib in chronic low back pain: results of two four-week, randomized, placebo-controlled trials.

OBJECTIVE: We recently reported the efficacy of rofecoxib in two randomized controlled trials in chronic low back pain (CLBP). The objectives of this report are to present data regarding the onset of efficacy of rofecoxib from these trials and propose methods for reporting onset. RESEARCH DESIGN AND METHODS: Patients were aged 18-75, with non-radicular CLBP for >or= 3 months. Patients were randomized to rofecoxib 25mg, 50 mg, or placebo once daily for 4 weeks. Assessments included Low Back Pain and Bothersomeness scales every morning and Relief from Starting Pain after the first dose at 0.5, 1, 2, 3, 4 h, bedtime, and next morning. Onset of meaningful relief was measured by Time to Confirmed 50% Reduction in Pain and Time to Confirmed 'Slightly' or 'Not At All' Bothersome Pain. Onset of perceptible pain relief was measured by Time to At Least 'A Little' Confirmed Pain Relief. RESULTS: 690 patients entered. Significantly more patients treated with rofecoxib had compared with 1/3 receiving placebo. Median meaningful relief compared to placebo: 60.4, 58.4, and 34.7% for rofecoxib 25mg, 50 mg, and placebo (p< 0.001). Median time to meaningful relief for rofecoxib was 2 days, 1 day sooner than placebo. Rofecoxib was superior to placebo by bedtime after the first dose. CONCLUSIONS: Approximately 2/3 of patients achieved meaningful pain relief with rofecoxib time to onset of meaningful relief was about 2 days, but superior relief over placebo was seen by bedtime after the first dose. Onset of perceptible pain relief was within 2 h. We propose that measures of onset of analgesic effect include the proportion of patients who achieve meaningful pain relief and in this subgroup, the time-to-onset of confirmed meaningful reduction in pain intensity, time-to-onset of confirmed pain relief, and time to first separation from placebo in the proportion of patients who achieve meaningful pain relief.

Adolescent↗
PubMedDate not supplied

Relationship between pain sensitivity and resting arterial blood pressure in patients with painful temporomandibular disorders.

OBJECTIVE: Patients experiencing temporomandibular disorders (TMD) show greater sensitivity to painful stimuli than age- and gender-matched control subjects. This enhanced pain sensitivity may result, at least in part, from an alteration in pain regulatory systems that are influenced by resting arterial blood pressure. In this study, we examined the relationship between resting systolic blood pressure and pain perception in 64 female TMD and 23 age-matched pain-free female subjects. METHOD: Resting arterial blood pressure and measures of thermal and ischemic pain threshold and tolerance were determined for each participant. Subjective ratings of thermal pain evoked by suprathreshold noxious thermal stimuli (45-49 degrees C) using a magnitude matching procedure were also obtained for both groups. RESULTS: TMD patients had lower thermal and ischemic pain thresholds and tolerances than pain-free subjects (ps < .05). Both groups provided equivalent intensity ratings to suprathreshold noxious thermal stimuli. A median split of each group based on resting systolic blood pressure revealed an influence of blood pressure on both thermal and ischemic pain perception for the Pain-Free group. The Pain-Free high resting blood pressure subgroup had higher thermal pain tolerances, higher ischemic pain thresholds, and provided lower magnitude estimates of the intensity of graded heat pulses compared with the Pain-Free low blood pressure subgroup. A trend toward a significant effect of blood pressure level on ischemic pain tolerance was also observed for the Pain-Free group. In contrast to the Pain-Free group, blood pressure level did not influence ischemic or thermal pain perception for TMD patients. Similar to the lack of effect of resting blood pressure on experimental pain perception in TMD patients, resting blood pressure was not related to measures of clinical orofacial pain in TMD patients. CONCLUSIONS: These findings confirm our previous findings that TMD patients are more sensitive to noxious stimuli and suggest that painful TMD may result, at least in part, from an impairment in central pain regulatory systems that are influenced by resting arterial blood pressure.

Adult↗
PubMed2003

Increased cerebral functional connectivity underlying the antinociceptive effects of hypnosis.

The neural mechanisms underlying the antinociceptive effects of hypnosis are not well understood. Using positron emission tomography (PET), we recently showed that the activity in the anterior cingulate cortex (midcingulate area 24a') covaries with the hypnosis-induced reduction of affective and sensory responses to noxious thermal stimulation [Faymonville et al., Anesthesiology 92 (2000) 1257-1267]. In the present study, we assessed changes in cerebral functional connectivity related to the hypnotic state, compared to simple distraction and the resting state. Nineteen highly hypnotizable right-handed volunteers were studied using H2(15)O-PET. The experimental conditions were hot noxious or warm non-noxious stimulation of the right hand during resting state, mental imagery and hypnotic state. Using a psychophysiological interaction analysis, we identified brain areas that would respond to noxious stimulations under the modulatory action of the midcingulate cortex in, and only in, the hypnotic state. Hypnosis, compared to the resting state, reduced pain perception by 50%. Pain perception during rest and mental imagery was not significantly different. Analysis of PET data showed that the hypnotic state, compared to normal alertness (i.e., rest and mental imagery), significantly enhanced the functional modulation between midcingulate cortex and a large neural network encompassing bilateral insula, pregenual anterior cingulate cortex, pre-supplementary motor area, right prefrontal cortex and striatum, thalamus and brainstem. These findings point to a critical role for the midcingulate cortex in the modulation of a large cortical and subcortical network underlying its influence on sensory, affective, cognitive and behavioral aspects of nociception, in the specific context of hypnosis.

Adult↗
PubMed1997

Self-efficacy for arthritis pain: relationship to perception of thermal laboratory pain stimuli.

OBJECTIVE: To examine how self-efficacy for arthritis pain relates to the perception of controlled laboratory pain stimuli. METHODS: Forty patients with osteoarthritis completed self-report measures of self-efficacy for arthritis pain. They then participated in a single experimental session in which measures of thermal pain threshold and tolerance were collected, as well as measures of the perceived intensity and unpleasantness of a range of thermal pain stimuli. RESULTS: Correlational analyses revealed that patients reporting high self-efficacy for arthritis pain rated the thermal pain stimuli as less unpleasant than those reporting low self-efficacy. When subjects scoring very high and very low in self-efficacy were compared, it was found that subjects scoring high on self-efficacy for arthritis pain had significantly higher pain thresholds and pain tolerance than those scoring low on self-efficacy. CONCLUSIONS: These results indicate that self-efficacy for arthritis pain is related to judgments of thermal pain stimuli. Implications for the understanding of arthritis pain and for future laboratory research are discussed.

Attitude to Health↗
PubMed1987

Effects of MHz ultrasound on electrical pain threshold perception in humans.

An electrode system was developed consisting of two 8 mm long 0.2 mm diameter silver-coated copper wires arranged parallel to each other 8 mm apart and held in contact with the skin by means of an acoustically transparent plastic adhesive tape. This system was attached to the upper arms of young adult volunteers who increased the voltage of the rectangular electrical pulses supplied to the electrodes until a reproducible sharp prickling pain sensation was perceived. A one inch diameter physiotherapy transducer was positioned over the electrode site so that ultrasound could be administered throughout the measurement period. The experiments were performed single blind to eliminate any subjective bias on the part of the volunteers. Preliminary experiments established that highly reproducible (+/- 3 to 4%) pain threshold perception values could be obtained, and that these values were not affected by changes in (a) the duration of the "on" time of the electrical pulses between 1.5 and 48 ms, (b) the contact pressure between the transducer and the electrode site, (c) the time interval between successive threshold measurements (providing that an unacceptable level of oedema was not produced around the electrodes), and (d) whether or not a test measurement was preceded by a control. Ultrasound exposure via a direct contact technique consistently produced a statistically significant (p less than 0.05) decrease in the perception threshold for electrical pain. This effect usually developed within 30-60 s and its magnitude increased both with increasing intensity (rising to 20.7 +/- 0.57% at an SATA intensity of 0.43 W/cm2 at 1.1 MHz) and with increasing frequency at the same ultrasonic intensity. Delivering the same amount of ultrasonic energy in the form of 2 ms bursts at several different peak intensities produced exactly the same reduction in pain threshold perception. These results indicate a thermal interaction mechanism, and similar threshold changes could be obtained by heating or cooling the electrode site by nonacoustic means. The inclusion of a thermocouple junction between the electrode wires showed that temperature increases of up to 10 degrees C could be produced when the transducer was in direct contact with the tape over the electrodes. The volunteers were not aware of these temperature increases which were primarily caused by heating of the transducer face. If the temperature of the skin surface is kept constant by interposing a thermostatted water path between the transducer and the electrode system, then similar ultrasound exposures had no detectable effects upon the electrical pain perception threshold.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1996

Electrically evoked cerebral potentials during esophageal distension at perception and pain threshold.

OBJECTIVE: To investigate esophageal sensory function in normal volunteers. METHODS: The method of evoking cerebral potentials (EPs) after electrical stimulation of the esophagus was applied in eight healthy male volunteers, 20-40 yr old. Electrical stimulation was obtained via bipolar Ag/AgCl electrodes attached to a latex balloon mounted on a catheter. The balloon was inflated stepwise to perception and pain thresholds. At the perception threshold for balloon distension, the intensity of electrical stimulation was increased stepwise to perception threshold for electrical stimulation, and subsequently to 2-fold, 4-fold, and 8-fold perception threshold. EPs were recorded from the vertex (Cz) and forehead (Fz, reference) and compared between the increasing electrical stimulation intensities and between perception and pain thresholds for mechanical stimulation. RESULTS: The results show that amplitudes of EPs significantly increased with increasing electrical stimulation intensities, whereas latencies of EPs were not affected. Latencies and amplitudes of EPs were comparable at perception and pain thresholds for esophageal distension. CONCLUSIONS: The study suggests that repetitive electrical stimulation of the human esophagus is predominantly mediated via vagal A-delta fibers. The unaltered EPs at the perception and pain thresholds suggest that vagal A-delta fibers are not involved in mediation of pain. The findings support the view that painful and nonpainful stimuli are mediated via different visceral afferents between the esophagus and brain in humans.

Adult↗
PubMed1996

Hypertension-associated hypalgesia. Evidence in experimental animals and humans, pathophysiological mechanisms, and potential clinical consequences.

A behavioral hypalgesia (increased response threshold to noxious stimuli) has been consistently, although not invariably, reported in spontaneous and experimental acute and chronic hypertension in the rat. Studies in human hypertension have also demonstrated a diminished perception of pain, assessed as pain thresholds or ratings. The sensitivity to painful stimuli correlated inversely with blood pressure levels, and this relationship extended into the normotensive range. Evidence in humans and rats points to a role of the baroreflex system in modulating nociception. In the rat, blood pressure-related antinociception may be due to attenuated transmission of noxious stimuli at the spinal level secondary to descending inhibitory influences that are projected from brain stem sites involved in cardiovascular regulation and that may depend on baroreceptor activation and/ or on a central "drive." Both endorphinergic and noradrenergic central neurons (the latter acting through postsynaptic alpha 2-receptors) have been shown to be involved, and other mediators probably also play a role. Functionally, blood pressure-related antinociception may represent an aspect of a more-complex coordinated adaptive response of the body to "stressful" situations. It is still uncertain whether in human essential hypertension hypalgesia is secondary to elevated blood pressure or whether both depend on some common mechanism. Studies on the effect of hypotensive treatment are too few to allow conclusions. According to one hypothesis, the reduction in pain perception caused by baroreceptor activation secondary to blood pressure elevation may represent a rewarding mechanism that may be reinforced with repeated stress and may be involved in the development of hypertension in some individuals. Hypertension-associated hypalgesia may have clinically relevant consequences, especially in silent myocardial ischemia and unrecognized myocardial infarction, both of which are more prevalent in hypertensive individuals.

Animals↗
PubMedDate not supplied

Ambulation after sheath removal: a comparison of 6 and 8 hours of bedrest after sheath removal in patients following a PTCA procedure.

OBJECTIVE: To determine whether ambulation of patients at 6 hours after sheath removal, compared with the institution's standard of 8 hours, would produce a change in hematoma formation, bleeding tendencies at the sheath introducer site, and/or patients' perceptions of pain after percutaneous transluminal coronary angioplasty (PTCA). DESIGN: A quasi-experimental research design was used. Each patient was randomly assigned to either the control group, which required 8 hours of bedrest after sheath removal, or the experimental group, which required 6 hours of bedrest after sheath removal. SETTING: Intensive care unit of a 400-bed urban teaching hospital in western Canada. SAMPLE: A convenience sample of 85 male and female patients admitted to the intensive care unit after an elective PTCA between June 1991 and November 1992. METHOD: Each subject was randomly assigned to 6 or 8 hours of bedrest after sheath removal. A demographic data tool, the short form of the McGill Pain Questionnaire, a Hematoma Assessment Instrument, and a Bleeding Tendency Assessment Instrument were used to collect the data. These instruments were administered to the patients at various intervals after sheath removal. DATA ANALYSIS: Results were analyzed to determine if the additional 2 hours of bedrest in the control group contributed to an increase in pain perception. Demographic information was analyzed by use of descriptive statistics. Parametric and nonparametric tests were also used to analyze the data. RESULTS: Ambulation of patients at 6 hours after sheath removal produced no significant increase in hematoma formation at the puncture site when compared with patients who ambulated 8 hours after sheath removal (p = 0.0001). There was a higher probability of a hematoma developing the day after the PTCA procedure if the activated clotting time (ACT) was high (p = 0.0034). Only one subject in the experimental group developed delayed bleeding; therefore, statistical analysis was unable to be performed on this data. When controlling for age, gender, type of procedure, previous PTCA, history of back pain, analgesic during the procedure, analgesic after the procedure, and cardiologist, the experimental group had significantly lower pain scores than the control group at 8 hours after sheath removal (p = 0.0001). CONCLUSION: This study supports our hypothesis that decreasing the amount of time patients are required to remain flat and supine is associated with no increase in hematoma and bleeding tendencies and is associated with a reduction in the perceptions of pain. The results appear to support ambulation of patients at 6 hours after sheath removal.

Adult↗
PubMed2006

Pain and relaxation (review).

The modern notion of pain and its clinical management, along with its physiological origins, is of exceeding interest to both clinicians and basic science researchers. While much is known about the control of pain via non-steroidal anti-inflammatory medications or comparative exogenous analgesics, little is known about the interplay between pain perception and its relationship with catecholamine molecules. We believe that the perception of pain and the body's self-attempt to alleviate it utilizing conventional homeostatic mechanisms via endogenous opiate release is mediated by key catecholamines, and that this effect is further modulated by nitric oxide. We further propose a new paradigm which links pain, endogenous opiates, and the catecholamines in a unique robust fashion demonstrating a complex symbiotic signaling system.

Animals↗