European journal of pain : EJP
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Diffuse noxious inhibitory controls (DNIC) as measured in rat and conditioned pain modulation (CPM), the supposed psychophysical paradigm of DNIC measured in humans, are unique manifestations of an endogenous descending modulatory pathway that is activated by the application of a noxious conditioning stimulus. The predictive value of the human CPM processing is crucial when deliberating the translational worth of the two phenomena. ⋯ This study provides novel evidence that a comparable noxious cuff pressure paradigm activates a unique form of endogenous inhibitory control in healthy rat and man. This has important implications for the forward translation of bench and experimental pain research findings to the clinical domain. If translatable mechanisms underlying dysfunctional endogenous inhibitory descending pathway expression (previously evidenced in painful states in rat and man) were revealed using cuff pressure algometry, the identification of new analgesic targets could be expedited.
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Although it has been suggested that the different cultural and social environments between countries contribute to variations in pain catastrophizing (PC), an international comparison of PC in patients with chronic pain has not yet been reported. Prior to undertaking this comparison, a cross-cultural assessment of the pain catastrophizing scale (PCS) was undertaken to explore the different factor structures among each translated version of the PCS. ⋯ Although the pain catastrophizing scale has been translated into approximately 20 languages, methodological quality during their translation process has not been systematically assessed. We found that all languages versions showed sufficient internal consistency when assessing whole items, however, there were inconsistent structural models among each translated version, leading to variant subdomain structures for rumination, magnification and helplessness.
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Central post-stroke pain (CPSP) can arise after lesions anywhere in the central somatosensory pathways, essentially within the spinothalamic system (STS). Although the STS can be selectively injured in the mesencephalon, CPSP has not been described in pure midbrain infarcts. ⋯ Selective spinothalamic injury caused by small lateral midbrain lesions is a very rare cause of central post-stroke pain that can remain undiagnosed for years. It appears to obey to haemorrhagic, sometimes post-traumatic lesions. Sudden development of contralateral burning pain with isolated spinothalamic deficits may be the only localizing sign, which can be easily objectively detected with electrophysiological testing.
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Review Meta Analysis
Intrathecal Dexmedetomidine and Postoperative Pain: A Systematic Review and Meta-analysis of Randomised Controlled Trials.
A systematic review and meta-analysis of randomized controlled trials (RCTs) was undertaken to evaluate the effect of intrathecal dexmedetomidine (DEX) on the duration of postoperative analgesia, postoperative pain scores and incidences of adverse effects. ⋯ The analgesic role of intrathecal DEX is promising due to its ability to significantly increase postoperative analgesic duration when compared with placebo. Its usage can be considered for patients undergoing surgeries with significant postoperative pain, particularly those intolerant of systemic analgesia. However, the optimal dose for various surgeries as well as its long-term neurological effects warrants further studies.