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Results for “Pain Perception”

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At least 865 records · Page 48Linked to original sources

PubMed1998

Repetitive pinching of the skin during lidocaine infiltration reduces patient discomfort.

BACKGROUND: The administration of a local anesthetic is often painful. OBJECTIVE: The purpose of this study was to determine whether rapidly shaking and pinching the skin during local anesthetic administration decreases pain perception. METHODS: The skin at the intended site of lidocaine injection was rapidly pinched between the thumb and forefinger just before the injection. Control patients received no intervention. Patients reported their pain perception using a visual analog scale (0 to 10). In the feasibility phase, patients were assigned to receive the pinching technique or no intervention, then randomized in the second phase. RESULTS: In phase 1, 34 patients received 42 excisions. Pain was significantly reduced (p=0.001) in the treatment group. In phase 2, 69 patients had 91 excisions. When adjusted for age and sex (data combined from phases 1 and 2), the treatment significantly reduced pain (p=0.03) when compared with no intervention. CONCLUSION: We describe a simple, noninvasive technique that significantly lowered perceived pain during the administration of unbuffered lidocaine with epinephrine local anesthetic.

Age Factors↗

PubMed1980

Changes in endorphins and 5-hydroxyindoleacetic acid in cerebrospinal fluid as a result of treatment with a serotonin reuptake inhibitor (zimelidine) in chronic pain patients.

Both the endorphin and the serotonin systems seem to be involved in pain perception, and a significant positive correlation between the levels of endorphins and 5-hydroxyindoleacetic acid (5-HIAA) in cerebrospinal fluid (CSF) has been established. In the present study, 20 chronic pain patients were treated with zimelidine, a rather selective inhibitor of serotonin reuptake, or placebo. Zimelidine produced a significant pain relief and a significant reduction of the levels of endorphins and 5-HIAA in CSF, while no significant changes occurred during placebo treatment. The results indicate that both the endorphin and the serotonin systems are involved in pain perception and that the systems are functionally related.

Adult↗

PubMed1984

Pathways for orofacial pain sensation in the trigeminal brain-stem nuclear complex of the Macaque monkey.

Eleven Macaque monkeys underwent a variety of lesions in the trigeminal afferent system; namely, tractotomy, rhizotomy, and radiofrequency destruction of various components of the bulbospinal trigeminal nuclear complex. Behavioral responses were evaluated before and after the lesions using a quantitative paradigm which measured lever-pressing in response to electrical stimulation of the dental pulp or facial skin, and by assessing adversive responses to facial cutaneous and intraoral pin-scratch. Thresholds for lever-pressing in response to cutaneous facial stimulation were elevated by tractotomy, elevated further by a combination of tractotomy and rhizotomy of the seventh, ninth, and 10th cranial nerves and cervical dorsal roots C1-3, and maximally elevated by complete radiofrequency destruction of the trigeminal nucleus caudalis. These lesions also abolished adversive responses to cutaneous facial pin-scratch. None of these lesion combinations, however, altered lever-pressing responses to dental pulp stimulation. Radiofrequency destruction of the trigeminal nuclei principalis, oralis, and interpolaris caused elevations of lever-pressing thresholds in response to dental pulp stimulation, and also smaller but statistically significant elevations on cutaneous electrical stimulation. Mild reductions in adversive responses to cutaneous pin-scratch were also produced by these rostral nuclear lesions, suggesting analgesia. The experiments suggest that primary afferent fibers for dental pain perception travel only in the trigeminal nerve and that these fibers relay via the trigeminal brain-stem nuclei principalis, oralis, and interpolaris. Primary afferent fibers for cutaneous facial pain perception travel in the trigeminal, facial, glossopharyngeal, and vagus nerves, and the upper cervical dorsal and ventral roots, and these afferents relay mainly in the trigeminal nucleus caudalis.

Animals↗

PubMed1984

Pain sensitivity, mood and plasma endocrine levels in man following long-distance running: effects of naloxone.

The effects of intense exercise on pain perception, mood, and plasma endocrine levels in man were studied under naloxone and saline conditions. Twelve long-distance runners (mean weekly mileage = 41.5) were evaluated on thermal, ischemic, and cold pressor pain tests and on mood visual analogue scales (VAS). Blood was drawn for determination of plasma levels of beta-endorphin-like immunoreactivity (BEir), growth hormone (GH), adrenocorticotrophic hormone (ACTH), and prolactin (PRL). These procedures were undertaken before and after a 6.3 mile run at 85% of maximal aerobic capacity. Subjects participated on two occasions in a double-blind procedure counterbalanced for drug order: on one day they received 2 i.v. injections of naloxone (0.8 mg in 2 ml vehicle each) at 20 min intervals following the run; on the other day, 2 equal volume injections of normal saline (2 ml). Sensory decision theory analysis of the responses to thermal stimulation showed that discriminability, P(A), was significantly reduced post-run under the saline condition, a hypoalgesic effect; response bias, B, was unaffected. Ischemic pain reports were significantly reduced post-run on the saline day, also a hypoalgesic effect. Naloxone reversed the post-run ischemic but not thermal hypoalgesic effects. Joy, euphoria, cooperation, and conscientiousness VAS ratings were elevated post-run; naloxone attenuated the elevation of joy and euphoria ratings only. Plasma levels of BEir, ACTH, GH, and PRL were significantly increased post-run. The results show that long-distance running produces hypoalgesia and mood elevation in man. The effects of naloxone implicate endogenous opioid neural systems as mechanisms of some but not all of the run-induced alterations in mood and pain perception.

Adrenocorticotropic Hormone↗

PubMedDate not supplied

Beta-endorphin levels during pregnancy and labor: a role in pain modulation?

Discovery of the endogenous opiate system of the brain has revolutionized the study of pain and pain management. In this study a convenience sample of 10 pregnant women, 16 nonpregnant women, and 18 men were studied to determine if changes in plasma beta-endorphin-like immunoreactivity affected pain perception during labor. Pregnant women had plasma levels of beta-endorphin significantly higher than nonpregnant women at the midpoint of their menstrual cycle, t = 3.74, df = 31, p = .007. Self-reported pain perception scores were not correlated with plasma beta-endorphin levels. However, as labor progressed, the women reported increased discomfort between contractions and during contractions while beta-endorphin levels increased only slightly. Close examination of the pain pattern indicates that pain perceived by the women between contractions increased at a greater rate than during contractions. This pattern suggests that opiate-active beta-endorphin may increase the ability of women to tolerate acute pain.

Female↗

PubMed1992

Perceptions of procedural pain: parents, nurses, and children.

The study's purpose was to determine if children, their parents, and their nurses differ in their perception of pain associated with health care procedures. A convenience sample of 40 subjects was obtained in a pediatric clinic. The subjects were triads of a child, the child's parent, and the nurse. The study utilized an exploratory design. Self-reports of pain were measured using the Oucher scale. Data were collected during a routine physical examination that included an immunization. Subjects rated the child's perceived pain after the immunization. No significant differences were found between the child's and the parent's scores. A significant difference was found between the child's and nurse's score (p = .0084). Initial findings suggest that there are differences in pain perception between nurses and children.

Attitude of Health Personnel↗

PubMed2006

Adequacy of pain relief in closed manipulative reduction of fracture and dislocation.

Adequate pain relief is a requisite for a successful closed manipulative reduction (CMR) of fractures and dislocations. This prospective study was undertaken to assess the mode and adequacy of pain relief given to patients undergoing such procedures at Seremban Hospital from the 1st April to the 31st May 2001. All patients with fractures and dislocations scheduled to undergo CMR were included in this study. The type of sedative agents and analgesia administered were recorded. Demographic data and the type of fracture or dislocation of the selected patients were documented. A visual analogue scale (VAS) for pain perception was given to both to the patients and the medical personnel who performed the procedure. All data were collected manually before entered into computerized database for analysis. Of 72 patients included in this study, 47% were Malay, 26% Indian, 21% Chinese and 6% others. There was male predominance and the patients' age ranged between 9 to 79 years (average 27.4 years). Upper limb injuries (79%) were mainly fractures of the radius and ulna (29%) and isolated fracture radius (21%). For the lower limb injuries (21%), combined tibia and fibula fractures constituted 10% of the total cases followed by isolated tibia fractures (10%) and hip dislocation (1%). The most common pain relieving agents given during the CMR were intravenous pethidine alone (43%) followed by combination of intravenous pethidine and valium (36%), intramuscular pethidine (17%) and intramuscular tramal (4%). The Visual Analogue Score (VAS) for pain perception revealed that 61% of the patients had moderate pain while 21% had severe pain during the course of the procedures. Suboptimal pain relief administered during CMR should prompt positive actions to ensure that the patient is not subjected to undue pain just for the sake of an acceptable fracture reduction.

Adjuvants, Anesthesia↗

PubMed1998

The fibromyalgia syndrome as a manifestation of neuroticism?

After elucidating the components and theory of neuroticism (N) as well as of psychosomatic complaints and their relationships to personality dimensions and to psychosomatic diseases, comparisons are performed between patients suffering from fibromyalgia syndrome (FMS) or related pain diseases with healthy subjects scoring high on personality dimensions related to neuroticism. FMS and pain patients score high on depression, anxiety, and experience of stress although questionnaire scores on depression are higher in subjects not exhibiting somatic features of the disease. High subjective pain sensitivity and low thresholds for pain perception are also common features in high N subjects and FMS patients. On the endocrinological level cortisol responses to challenge tests with CRH as well as prolactin responses to TRH are higher in FMS patients than in high N healthy subjects indicating an endocrinological difference. A common feature, however, is the lack of adaptability in the two groups, since neurotics are in particular characterized by a low capacity to shift their behavior from one state to the other (waking-sleeping, working-relaxing), to re-adapt to baseline levels after endocrinological or physiological stress responses, or to adjust to conditions of shift work. This is reflected by chronobiological disturbances in FMS patients and could also explain their maintainance of pain perception, because they are incapable of correcting conditioned pain-producing muscle tension.

Adaptation, Psychological↗

PubMed2003

Low back pain in Flemish adolescents and the role of perceived social support and effect on the perception of back pain.

AIM: To document the prevalence of low back pain (LBP) in Flemish adolescents and to recognize the association between perceived social support and affect and medical consultation and reduction of activities. METHODS: The study comprised 620 adolescents. A questionnaire was used to elicit the characteristics of LBP. Perceived social support and affect were investigated using the Personal Resource Questionnaire (PRQ) and the Positive Affect Negative Affect Scale (PANAS), respectively. Comparisons were made between adolescents with LBP and adolescents without LBP. Within the LBP group, answers from adolescents appealing for medical advice were compared with those who did not seek advice. Another comparison was done between adolescents who reduced their activities and those who did not. Descriptive statistics, the median test for two samples, a chi2 test or Fisher's exact probability test and logistic regression analysis were used for data analysis. RESULTS: Month prevalence of LBP was 24.7%. Thirteen adolescents visited a physician or received treatment, pain severity being the sole factor associated with the decision. Fifteen adolescents reduced their sports activities and 11 reduced or stopped other leisure activities. Pain severity and negative affect were the main associated factors. CONCLUSION: The results of the present study encourage further research on the role of pain perception and the influence of psychosocial factors on back pain in adolescents.

Adolescent↗

PubMed1998

Proglumide as a morphine adjunct in cancer pain management.

Proglumide, a cholecystokinin (CCK) antagonist, has been shown to have agonist effects at extremely low doses on both endogenous and exogenous opioid systems. To determine the effectiveness and the side effects of proglumide as an opioid agonist, a double-blind crossover study was conducted in 60 patients with cancer pain who were treated with opioid analgesics. Forty-three patients completed both treatment arms: (a) full analgesic dose plus placebo (the patient's usual analgesic dose, individualized to drug dose and route) and (b) one-half analgesic dose plus 50 mg of proglumide. An analysis of eight pain descriptors was performed to determine whether or not these treatments were associated with a difference in patients' pain perception. The level of patient anxiety differed between the two arms, but was inconsistent over time. There were no side effects detected with proglumide, as determined by clinical monitoring and patient questionnaire. No differences in pain perception were detected between the study arms. The latter finding is consistent with an augmentation of morphine analgesia, but without additional controls, the equivalency of the two arms cannot be determined with certainty. Nonetheless, this study suggests that proglumide may have use as an opioid adjunct in patients with cancer pain.

Analgesics, Opioid↗

PubMed2006

Reduced expression of endothelin B receptors and mechanical hyperalgesia in experimental chronic diabetes.

Diabetic neuropathy is one of the major complications of diabetes mellitus. Small nerve fibers degenerate early in the disease, leading to symptoms ranging from hyperalgesia to loss of pain and temperature sensation. However, the cellular and molecular mechanisms responsible for abnormal pain perception in diabetes have not been identified. Both type-A and type-B endothelin receptors (ETAR and ETBR, respectively) are present in sensory nerves and appear to regulate neuropathic and inflammatory pain. In this study, we compared the expression of endothelin receptors and nociceptive responses in normal and experimentally diabetic rats. Diabetic animals exhibited both an increase in the withdrawal responses to high threshold stimuli (mechanical hyperalgesia) and to light touch stimuli (tactile allodynia). Immunohistochemical and Western blot analysis revealed that diabetic rats have significantly reduced expression of ETBR in sciatic nerves, while no changes were observed in dorsal root ganglia (DRG). In contrast, the expression of ETAR in either sciatic nerves or DRG of diabetic rats was not altered. Importantly, ETBR-deficient transgenic rats showed alterations in pain perception similar to those observed in diabetic rats. These results suggest that changes in the expression of ETBR in peripheral nerve may contribute to the development of mechanical hyperalgesia and tactile allodynia in chronic diabetes.

Animals↗

PubMed1993

A test of exercise analgesia using signal detection theory and a within-subjects design.

Evidence for the existence of exercise-induced analgesia has been weak, inconsistent, or anecdotal. The present study addresses criticisms of previous research by using a signal-detection analysis of pain perception in a within-subjects, repeated-measures research design with 22 endurance athletes who exercised in a naturalistic setting. Analysis showed discriminability measures from the lower intensities of a radiant-heat pain-perception task were significantly lower after exercise than the subjects' discriminability after a no-exercise period. This is consistent with discriminability decreases seen in studies of subjects who are under the influence of analgesic chemicals such as morphine and nitrous oxide. Discriminability differences were not seen in this study at the higher intensities of the stimulus, suggesting that exercise generates perceptual changes that may not reach pain-mediating levels. Visual analogue data suggest cognitive and motivational factors also play a role in report of pain after exercise.

Adult↗

PubMed1995

A 5-HT3 receptor antagonist fails to prevent cisplatin-induced toxicity in immature rat spinal cord.

The use of high doses of cisplatin in treating cancers has been limited by two major adverse effects--emesis and peripheral neuropathies. The emesis has become largely controlled by the introduction of a new class of drugs--the 5-HT3 receptor antagonists. The current study was undertaken to determine if these drugs would also prevent cisplatin-induced neuropathy. We have used a developing rat as an animal model and determined the effects of cisplatin on morphology (loss of spinal cord calcitonin gene-related peptide (CGRP)-containing neurons) and behavior (gait abnormalities and pain perception). Rat pups from the age of 5 days were treated twice weekly for 4 weeks with cisplatin (1 mg/kg), the 5-HT3 antagonist MDL 72222 (3 mg/kg) or both. The animals were tested for pain perception (using tail-flick latencies) at 17 and 21 days of age and for a gait abnormality at 24 days of age. At 34 days of age, the animals were perfused and the lumbar region of the spinal cords stained immunocytochemically for CGRP. Our results show that cisplatin treatment resulted in a dramatic loss of CGRP neurons in the dorsal horn of the spinal cord and a corresponding increase in the animals' threshold for pain. In addition, the animals showed a pronounced gait abnormality, characterized by 'toeing-in'. Treatment with MDL 72222 not only failed to protect against the loss of CGRP neurons but also worsened the gait abnormalities seen after cisplatin treatment alone. These studies confirm and extend the list of morphological and functional adverse effects of cisplatin treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗

PubMed2000

Prospective randomized blinded trial of pulmonary function, pain, and cosmetic results after laparoscopic vs. microlaparoscopic cholecystectomy.

BACKGROUND: The size of laparoscopic instruments has been reduced for use in abdominal video endoscopic surgery. However, it has yet to be proven that microlaparoscopic surgery will actually result in clinically relevant benefits for patients. METHODS: Fifty patients were randomized in a blinded fashion to receive either elective laparoscopic (MINI), (n = 25) or microlaparoscopic (MICRO) (n = 25) cholecystectomy. Pulmonary function (FVC, FEV (1)), analgesic consumption during patient-controlled analgesia (PCA), pain perception by visual analogue score (VAS), and the cosmetic result (by the patient's self-assessment) were evaluated postoperatively as clinically relevant end points. RESULTS: Age, sex, body mass index (BMI), preoperative pulmonary function, pain perception, and operative time were similar for the two groups. At 8:00 PM on the day of surgery, FVC (MINI: 1.96 L [range, 1.48-2.48]; MICRO: 2.13 L) [(range, 1.61.-2.50)] and FEV (1) (MINI: 1.17 L/sec) [range, 0.87-1. 48]; MICRO: 1.34 L/sec [range, 1.05.-2.14] were also similar (each p = 0.5). From surgery to the 3rd postoperative day, cumulative PCA morphine doses were comparable (MINI: 0.15 mg/kg bw [range, 0.09-0. 23]; MICRO: 0.21 mg/kg bw [range, 0.10-0.42]; p = 0.4), but overall VAS scores for pain while coughing were higher in the laparoscopic group (406 [range, 358-514]) than in the microlaparoscopic group (365 [range, 215-427]; p = 0.02). The cosmetic result was judged to be slightly superior by the microlaparoscopic patients (10 [range, 9-10]), as compared to those in the laparoscopic (9 [range, 8-10]) group (p = 0.04). CONCLUSION: Because microlaparoscopic cholecystectomy has some minor advantages over laparoscopic surgery, it should be considered for use in selected patients.

Adult↗

PubMed2001

Development of a pain attitudes questionnaire to assess stoicism and cautiousness for possible age differences.

This study aimed to develop a pain attitudes questionnaire (PAQ) and examine its reliability and validity for use in assessing the constructs of stoicism and cautiousness relevant to pain perception. The questionnaire was administered to 373 healthy community-dwelling individuals who were subsequently divided into four age groups to test for differences in stoicism and cautiousness, two attitudes that have previously been claimed to influence pain perception and report among older adults. Factor analysis revealed that two dimensions of stoicism and two dimensions of cautiousness are measured by the scale, with reticence and superiority characterizing the first construct and self-doubt and reluctance characterizing the second. There was support for the scale's reliability and validity. Age-related increase in degree of reticence to pain, self-doubt, and reluctance to label a sensation as painful was found, emphasizing the need for careful consideration of pain attitudes in older patients who may underreport their pain symptoms.

Adolescent↗

PubMed2000

Electrical (faradic) stimulation versus active mobilization exercise in the physical management of post-surgical temporomandibular joint hypomobility.

This clinical study compared the efficacy of faradic stimulation and active mobilization exercises in the physical management of patients with post-surgical immobilization of the temporomandibular joint (TMJ) resulting in hypomobility of the joint. Eight volunteer dental patients with post-surgical immobilization TMJ hypomobility at the University College Hospital (U.C.H.), Ibadan, Nigeria participated in the study. Duration of TMJ immobilization was between 6 and 10 weeks (mean 7.13 +/- 1.55). Patients were alternately assigned to two groups as they became available. Patients in group A received mild infra-red radiation to the TMJ region and faradic stimulation to the muscles that move the joint while patients in group B had mild infra-red radiation and TMJ mobilization exercises. Treatment continued until pain relief and full range of the TMJ were attained. However after three treatment sessions, attendance became irregular because the patients were satisfied with their recovery. Pain perception was measured using the visual analogue scale. Interincisal opening was measured using a pair of mathematical set divider and a measuring ruler. The results showed that both faradic stimulation and exercises significantly improved the interincisal opening and pain perception although electrical stimulation improved mouth opening more significantly than active exercise.

Adolescent↗

PubMed1996

Pain intensity and blood pressure reactions during a cold pressor test in IDDM patients.

OBJECTIVE: To determine the contribution of altered pain perception to the impaired blood pressure reactions during a cold pressor test in diabetic patients. Reduced blood pressure increases have been observed in diabetic patients during a cold pressor test and have been attributed to an impaired efferent sympathetic function. RESEARCH DESIGN AND METHODS: We investigated pain intensities and blood pressure reactions simultaneously during a cold pressor test in 30 IDDM patients (diabetes duration 12 +/- 6 years, HbA1c 7.5 +/- 1.4%) and in 30 normal control subjects with comparable sex distribution, age, height, BMI, physical fitness, and smoking habits. RESULTS: Initial pain intensities and respective time courses did not differ between the two groups. The initial blood pressure response was significantly smaller in diabetic patients (P < 0.002). Correlations of diastolic blood pressure increases in diabetic patients with initial pain intensity, standard cardiovascular reflex tests, age, clock time, smoking habits, disease duration, and actual blood glucose concentrations did not reach statistical significance. Pain intensity and diastolic blood pressure increases, however, were correlated to HbA1c concentrations in diabetic patients. CONCLUSIONS: Impaired pain perception is not the cause of the impaired reactions of blood pressure in diabetic patients during the cold pressor test, leaving very early deterioration of either cerebral processing of pain stimuli, cardiac function, efferent sympathetic nerves, or decreased vascular reactivity as possible explanations.

Adult↗

PubMed2002

Imaging how attention modulates pain in humans using functional MRI.

Current clinical and experimental literature strongly supports the phenomenon of reduced pain perception whilst attention is distracted away from noxious stimuli. This study used functional MRI to elucidate the underlying neural systems and mechanisms involved. An analogue of the Stroop task, the counting Stroop, was used as a cognitive distraction task whilst subjects received intermittent painful thermal stimuli. Pain intensity scores were significantly reduced when subjects took part in the more cognitively demanding interference task of the counting Stroop than in the less demanding neutral task. When subjects were distracted during painful stimulation, brain areas associated with the affective division of the anterior cingulate cortex (ACC) and orbitofrontal regions showed increased activation. In contrast, many areas of the pain matrix (i.e. thalamus, insula, cognitive division of the ACC) displayed reduced activation, supporting the behavioural results of reduced pain perception.

Adult↗