European journal of pain : EJP
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Comparative Study Controlled Clinical Trial
Effects of untreated preoperative essential hypertension on post-operative pain after major abdominal surgery.
Hypertension has been associated with hypoalgesia. This prospective study was designed to test the effects of untreated preoperative essential hypertension on post-operative pain intensity and morphine requirement after major abdominal surgery. ⋯ Untreated essential hypertension is associated with significantly reduced post-operative morphine requirement and pain intensity, suggesting hypertension-associated hypoalgesia.
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The aim of this study was to determine if genetic variation in the pain-modulating gene DREAM and its pathway genes influence susceptibility to reporting musculoskeletal pain in the population. ⋯ Genetic variation in the DREAM pathway genes was associated with the extent of pain reporting in a population-based cohort. These findings were not replicated in a single independent cohort; however, given the potential of this pathway as a therapeutic target, further investigation in additional cohorts is warranted.
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Temporal summation of second pain (TSSP) is relevant for the study of central sensitization, and refers to increased pain evoked by repetitive stimuli at a constant intensity. While the literature reports on participants whose pain ratings increase with successive stimuli, response to a TSSP protocol can be variable. The aim of this study was to characterize the full range of responses to a TSSP protocol in pain-free adults. ⋯ Using a fixed thermal paradigm, pain-free adults exhibit substantial variability in response to a TSSP protocol not well characterized by group-mean slopes. Studies are needed to determine TSSP response patterns in clinical samples, identify predictors of response and determine the clinical implications of response variability.
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We investigated whether patients with painful chronic pancreatitis (CP) present abnormalities in the cerebral response to experimental pain stimuli. ⋯ Taken together, CP patients had an abnormal cerebral response to repetitive thermal stimuli. This was most prominent after stimulation of the upper abdominal area. As this area share spinal innervation with the pancreatic gland, these findings likely mirror distinctive abnormalities in cerebral pain processing.
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Acceptance as a process variable in relation to catastrophizing in multidisciplinary pain treatment.
The underlying processes of change that contribute to the effectiveness of multidisciplinary pain treatment require clarification. Previous research has found support for pain acceptance as a process variable in acceptance-based treatment. Preliminary findings indicate that pain acceptance may also be a process variable in traditional cognitive behavioural therapy (CBT). The aim of this study was to investigate the role of pain acceptance as a process variable in CBT relative to two empirically supported process variables, namely catastrophizing and pain intensity. ⋯ Although not specifically targeted in CBT treatment, acceptance of pain was an important process variable that contributed to CBT treatment outcomes after controlling for changes in pain intensity and catastrophizing. Implications for future research and clinical practice are discussed.