European journal of pain : EJP
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Randomized Controlled Trial Comparative Study
The relative efficacy of mindfulness versus distraction: The moderating role of attentional bias.
This study investigated whether the ability to disengage quickly from pain-related stimuli moderated the relative efficacy of a mindfulness-based intervention versus distraction in response to an experimental pain task. ⋯ This study demonstrated the efficacy of a novel, exposure-based mindfulness technique for pain tolerance and showed that those who disengaged easily from pain stimuli benefited most. This brief task could be clinically useful, particularly for those who are not overly focused on their pain symptoms.
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Review Practice Guideline
Standards for the management of cancer-related pain across Europe. A position paper from the EFIC Task Force on Cancer Pain.
Pain is a common symptom in patients who survive cancer and in those who live with progressive advanced disease. Evidence from meta-analyses suggests that pain remains poorly controlled for a large proportion of patients; barriers to good management include poor assessment of pain, inadequate support for patient self-management and late or inadequate access to strong opioid analgesia in those with advanced disease. ⋯ Pain affects up to 40% of cancer survivors and affects at least 66% of patients with advanced progressive disease, many of whom experience poor pain control. These 10 standards are aimed to improve cancer pain management, promote the quality of care of patients and reduce variation across Europe.
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Pain expectancies are associated with altered pain sensitivity in individuals with chronic pain. However, little is known about the processes by which pain expectancies impact pain processing. This study assessed the association between pain expectancies and temporal summation (TS) of pain, and examined whether pain catastrophizing mediated this association. ⋯ Individuals with chronic low back pain who expect higher levels of pain and catastrophize about their pain are more likely to experience altered pain sensitivity. Our results point to catastrophizing as a mechanism of action through which psychological factors may operate and lead to the development and maintenance of chronic low back pain.
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Hypersensitivity and altered sweating are often present in neuropathy patients. Nerve lesions are known to produce sudomotor dysfunctions but also patients suffering from complex regional pain syndrome, CRPS1-a condition without a nerve lesion-present with sweating disorders. ⋯ Sweat output changes in mice after bone trauma, potentially indicative of posttraumatic processes leading to CRPS in humans.
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Total intravenous anesthesia with propofol has been shown to reduce postoperative pain in some clinical studies, but knowledge of its underlying analgesic mechanism remains limited. In this study, we compared the analgesic effects of propofol versus isoflurane in an animal model of postoperative pain and evaluated its underlying molecular mechanisms. ⋯ These findings may provide a new mechanism for the postsurgical analgesic effect of propofol, which is particularly interesting during the subacute period after surgery as it is the critical period for the development of persistent postsurgical pain.