European journal of pain : EJP
-
Distraction is an intuitive way of coping with pain and is often used in children's pain treatment programs. However, empirical evidence concerning the effectiveness of distraction is equivocal. One potential explanation might be that distraction does not work for everyone in every situation. ⋯ Results showed that participants in the distraction group were engaged in the distraction task, and reported to have paid less attention to pain than participants in the control group. However, distraction was ineffective in reducing cold pressor pain, and even intensified the pain experience in high catastrophizing children. Caution may be warranted in using distraction as a 'one size fits all' method, especially in high catastrophizing children.
-
Pain has both sensory-discriminative and emotional-affective dimensions. Previous studies demonstrate that electroacupuncture (EA) alleviates the sensory dimension but do not address the affective. An inflammatory pain rat model, produced by a complete Freund adjuvant (CFA) injection into the hind paw, was combined with a conditioned place avoidance (CPA) test to determine whether EA inhibits spontaneous pain-induced affective response and, if so, to study the possibility that rostral anterior cingulate cortex (rACC) opioids underlie this effect. ⋯ EA treatment did not produce reward or aversive effect. Intra-rACC administration of D-Phe-Cys-Tyr-D-Trp-Orn-Thr-Pen-Thr amide (CTOP), a selective mu opioid receptor antagonist, but not norbinaltorphimine (nor-BNI), a selective kappa opioid receptor antagonist, blocked EA inhibition of the affective dimension. These data demonstrate that EA activates opioid receptors in the rACC to inhibit pain-induced affective responses and that EA may be an effective therapy for both the sensory-discriminative and the affective dimensions of pain.
-
Multicenter Study Comparative Study Clinical Trial
Evaluation of the comparative analgesic effectiveness of transdermal and oral opioids in cancer patients: a propensity score analysis.
Transdermal delivery systems containing fentanyl or buprenorphine, despite the relatively lack of comparative studies, have reached an impressive share of the market in several countries. In the context of a wider observational study, we applied the propensity score to test the comparative effectiveness of the two routes of administration (oral vs. transdermal). ⋯ The application of the propensity score has helped understand better the actual effectiveness of transdermal delivery systems that are at least equivalent to the oral opioids, and even more effective for pain intensity reduction.
-
Comparative Study
Gender role expectations of pain mediate sex differences in cold pain responses in healthy Libyans.
Previous studies found a relationship between response to experimentally-induced pain and scores for the gender role expectations of pain (GREP) questionnaire. Findings were similar in individuals from America, Portugal and Israel suggesting that gender role expectations may be universal. The aim of this study was to translate and validate Arabic GREP using Factor Analysis and to investigate if sex differences to cold-pressor pain in healthy Libyan men and women are mediated through stereotypical social constructs of gender role expectations and/or pain-related anxiety. ⋯ There were significant differences between sexes in 6 out of 12 GREP items (p < 0.004 after Bonferonni adjustment). The results of mediational analysis showed that GREP factors were the mediators of the effects of sex on pain threshold (z = -2.452, p = 0.014 for Self Sensitivity); (z = -2.563, p = 0.01, for Self Endurance) and on pain tolerance (z = -2.538, p = 0.01 for Self Endurance). In conclusion, sex differences in response to pain were mediated by gender role expectations of pain but not pain-related anxiety.