The Clinical journal of pain
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Although nicotine has an analgesic effect, the incidence and severity of chronic pain is higher in smokers than nonsmokers. Acute pain is more intense in smokers during the perioperative period. This study evaluated whether smokers require higher doses of opioid to reduce pain when they undergo surgery. ⋯ Our results suggest that smokers undergoing distal gastrectomy with gastroduodenostomy required more opioid than nonsmokers for postoperative pain. Old age, smoking status, and increment of remifentanil use seemed to be predictors of postoperative opioid consumption.
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The impaired attenuation of pain by the application of a noxious conditioning stimulus at a segmentally distinct site, known as conditioned pain modulation (CPM), has been implicated in clinical pain states. Chronic lateral epicondylalgia (LE), which is characterized by lower pressure pain thresholds (PPTs) at sites remote to the affected elbow and spinal cord hyperexcitability, is a clinical pain state that might plausibly involve less efficacious CPM. This study aimed to determine whether LE exhibits a less efficacious CPM compared with that in pain-free controls. ⋯ The results that suggest an impaired ability to modulate pain might be associated with the previously observed spinal cord hyperexcitability and the mechanical hyperalgesia that characterizes LE.
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Individuals experiencing neuropathic pain (NP) after spinal cord injury (SCI) present with a variety of pain descriptors in different combinations and at different intensities. These sensory features form distinct patterns, known as sensory symptom profiles. ⋯ Classification of SCI-NP patients into the 5 groups identified in the present study based on their distinct sensory symptom profiles may allow identification of those most likely to respond to a specific analgesic approach.
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Pain catastrophizing has been associated with higher pain intensity, increased risk of developing chronic pain and poorer outcomes after treatment. Despite this, the mechanisms by which pain catastrophizing influences pain remain poorly understood. It has been hypothesized that pain catastrophizing may impair descending inhibition of spinal level nociception. The aims of this study were to compare spinal nociceptive processing in people with chronic widespread pain and pain-free controls and examine potential relationships between measures of pain catastrophizing and spinal nociception. ⋯ Despite increased excitability and decreased inhibition of spinal nociception in patients with chronic widespread pain, we could find no evidence of a significant relationship between pain catastrophizing and measures of spinal nociceptive processing.
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Observational Study
Symptoms of Depression and Risk of Low Back Pain: A Prospective Co-twin Study.
To investigate whether symptoms of depression increase the risk of low back pain (LBP), after adjusting for genetic and environmental influences. ⋯ The magnitude of the association between depression and LBP seems to be small and may be confounded by genetic and early shared environment influences, although firm conclusions could not be made due to small sample size in the case-control analysis. In addition, the observed association is dependent on the method of assessment used for both conditions.