Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur
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Randomized Controlled Trial Multicenter Study
The effects of 2 µg and 4 µg doses of dexmedetomidine in combination with intrathecal hyperbaric bupivacaine on spinal anesthesia and its postoperative analgesic characteristics.
To compare the postoperative analgesic characteristics and side effects of two different doses of intrathecal dexmedetomidine in combination with hyperbaric bupivacaine, and to evaluate the effects of these combinations on spinal anesthesia. ⋯ Two different doses of dexmedetomidine, an α2-adrenoceptor agonist with analgesic effects, resulted in an increased duration of analgesia and efficacy, decreased postoperative analgesic use and was associated with no notable adverse effects.
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The endogenous modulation of pain can be assessed through conditioned pain modulation (CPM), which can be quantified using subjective pain ratings or nociceptive flexion reflexes. However, to date, the test-retest reliability has only been investigated for subjective pain ratings. ⋯ Subjective pain ratings and nociceptive flexion reflexes show comparable test-retest reliabilities, but they reflect different components of CPM. While subjective pain ratings appear to incorporate cognitive influences to a larger degree, reflex responses appear to reflect spinal nociception more purely.
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Despite a growing body of literature investigating sex differences with regard to pain, surprisingly little research has been conducted on the influence of various aspects of self-identity, including gender expression and sexual orientation, on pain sensitivity within each sex, particularly among women. In men, dispositional femininity is linked to greater clinical pain and trait masculinity is associated with higher pain thresholds. ⋯ Larger investigations of the psychophysiological relationships among sexual orientation, gender expression and pain sensitivity are warranted. These findings may have implications for differences in clinical pain sensitivity of lesbian and bisexual women compared with heterosexual women.