European journal of pain : EJP
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We have recently demonstrated dose-related analgesic-induced reductions in the occurrence of 7 behavioural activities following midline laparotomy in rats. For these behaviours to be useful in evaluating pain in laboratory rats they must be shown to occur after different types of surgery, and frequently enough to allow rapid scoring of animals. Here, the relevant behaviours were used to test the analgesic efficacy of meloxicam with a variation of our previous laparotomy model. ⋯ Irrespective of whether analyses included only 5 or all 10 min of the observation period, the relevant behaviours occurred significantly more often in rats given saline or low dose meloxicam than in those given 1 or 2 mg/kg of meloxicam, or any dose of carprofen. We conclude that this technique of quantifying post-surgery behaviour is an effective pain scoring method following abdominal surgery in rats, and that 1 mg/kg meloxicam significantly attenuates laparotomy induced pain. Since only a short observation period is required, this approach represents an important practical advance in assessing abdominal pain severity and clinical drug potency.
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Randomized Controlled Trial Clinical Trial
Suppression of motor evoked potentials in a hand muscle following prolonged painful stimulation.
Earlier investigations have shown that stimulation of peripheral afferent nerves induces prolonged changes in the excitability of the human motor cortex. The present study compared the effect of experimental pain and non-painful conditioning stimulation on motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) in the relaxed first dorsal interosseous (FDI) and flexor carpi ulnaris (FCU) muscles. The MEPs were measured in 10 healthy subjects, and stimulus-response curves were generated before and after each of four stimulation paradigms conducted in random order on separate occasions: (a) control; (b) "dual stimulation" consisting of electrical stimulation of the FDI motor point paired with TMS; (c) painful infusion of hypertonic saline in the FDI muscle; and (d) pain combined with dual stimulation. ⋯ In two additional subjects, the responses evoked in FDI by direct stimulation of the descending corticospinal tracts were significantly depressed following painful stimulation of the FDI, although the ulnar-evoked M-waves remained constant. It is concluded that muscle pain is followed by a period with profound depression of MEPs amplitudes in the resting muscle, but that these changes are at least in part due to a lasting depression of the excitability of the motoneurones in the spinal cord. Hence, painful stimulation differs from non-painful, repetitive stimulation, which facilitates the corticomotor pathway.
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Clinical Trial
Multi-modal induction and assessment of allodynia and hyperalgesia in the human oesophagus.
Experimental pain models based on single stimuli have to some degree limited visceral pain studies in humans. Hence, the aim of this study was to investigate the effect of multi-modal visceral pain stimuli of the oesophagus in healthy subjects before and after induction of visceral hyperalgesia. We used a multi-modal psychophysical assessment regime and a neurophysiological method (nociceptive reflex) for the characterisation of the experimentally induced hyperalgesia. ⋯ Visceral hyperalgesia/allodynia can be induced experimentally and assessed quantitatively by the newly introduced multi-modal psychophysical assessment approach. The significant changes of the experimentally evoked referred pain patterns and of the nociceptive reflex evoked from a distant somatic structure indicate that even short-lasting visceral hyperalgesia can generate generalised sensitisation.
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Comparative Study Clinical Trial Controlled Clinical Trial
Hypoalgesia to pressure pain in referred pain areas triggered by spatial summation of experimental muscle pain from unilateral or bilateral trapezius muscles.
Animal and human experimental studies have suggested the importance of spatial summation in the nociception processing and in the activation of descending inhibition. However, the relationship between the areas (size) of muscles stimulated and the recruitment of descending inhibition has not been addressed. Consequently, we tested whether bilateral versus unilateral injection of hypertonic saline into trapezius muscles caused hypoalgesia to pressure pain (pressure pain thresholds, PPTs) in the local pain areas (the trapezius muscles) and the referred pain areas (the posterolateral neck muscles). ⋯ In the referred pain areas, the PPTs 7.5 and 15 min after the second injection were significantly increased compared with the first injection, while no changes in the PPT were observed in local and referred pain areas after unilateral injection. This suggests that the induction of descending inhibition was triggered by spatial summation during the later phase of experimentally induced muscle pain. The present experimental model might be used for further investigation of descending inhibition related to the spatial characteristics of nociceptive stimuli in humans.
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Determinants of health-related quality of life in patients with persistent somatoform pain disorder.
Health-related quality of life (HRQOL) has been investigated widely in patients with chronic pain, but no study has focused particularly on the situation of patients with persistent somatoform pain disorder. ⋯ Patients with persistent somatoform pain disorder feel severely impaired. A clear pattern emerges for negative effects of the coping styles Increasing Pain Behaviors and Catastrophizing, while the identification of beneficial coping failed.