European journal of pain : EJP
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In the present article, the relationships between pain, coping, functional capacity and psychological well-being are examined in a population of older patients (>/=60 years; n=202) treated for a variety of somatic complaints in a university-affiliated hospital. Results indicate that moderate to extreme pain is common in older patients and often occurs in several body regions simultaneously. Extreme pain in one or more body regions is associated with reduced daily functional capacity, lower values for life satisfaction and self-evaluated competence, and more negative attitudes towards the present and future. ⋯ Results of a hierarchical cluster analysis reveal interindividual differences in coping approaches among older patients suffering from extreme pain; they also emphasize the importance of cognitive strategies and life-review coping. Relevance for clinical practice with older pain patients is discussed. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.
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The present study has assessed the relationship between formalin-induced nociception and formalin-induced inflammation by comparing the dose-related effects of anti-inflammatory treatments on both nociceptive scores and plasma extravasation in the rat hind paw in response to high and low concentrations of formalin. The degree of plasma extravasation produced by 1% formalin did not differ significantly from that produced by the same volume of saline, and was not significantly affected by either of the anti-inflammatory agents. The 5% formalin injection produced significant plasma extravasation that was dose-dependently reduced by both dexamethasone and ibuprofen. ⋯ The present study suggests that there is a positive correlation between the nociceptive and inflammatory effects of formalin in the rat hind paw. However, only a high concentration of formalin, which produces significant plasma extravasation, is capable of demonstrating the antinociceptive effects of anti-inflammatory agents, and the effects are restricted to the late phase of the formalin test. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.
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This study found that in lightly-anesthetized rats a unilateral micro-injection of glutamate (200 mm, 0.5 µl) into the thalamic nucleus submedius (Sm) markedly depressed the radiant heat-evoked tail flick (TF) reflex. After injection, the mean TFL increased 25.6+/-6.5% (n=24) of the baseline at 5 min, up to a peak value (48.4+/-7.2%) at 20 min, and recovered to the baseline level at 60 min. This inhibitory effect was dose-related and repeatable over a time interval of 1.0-1.5 h in the same animal. ⋯ These results confirmed our previous findings that electrical stimulation of Sm depressed the rat TF reflex and that this inhibitory effect was blocked by electrolytic lesion of the VLO or PAG. Therefore, the present study provides further support for the hypothesis that Sm plays an important role in modulation of nociception, and that its effects are mediated by the VLO-PAG pathway, leading to activation of the brainstem descending inhibitory system and depression of the nociceptive inputs at the spinal cord level. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.
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Tramadol is a widely-used analgesic for pre- and post-operative pain which has a different pharmacological profile to that of classical opioids, since it does not induce respiratory depression, constipation, sedation, tolerance or dependence. However, tramadol frequently produces nausea and vomiting as side-effects. In the present study, the interactions between tramadol and several adrenergic and serotonergic compounds with antinociceptive activity were studied by isobolographic analysis. ⋯ The synergies observed with these combinations suggest a complex modulation of the descending noradrenergic and serotonergic systems that exert inhibitory influences on the transmission of nociceptive information, probably in addition to effects on receptors in the primary neurons of the spinal cord. The co-administration of analgesic drugs that produce superadditive effects constitutes a significant new avenue for the treatment of pain, since a similar level of antinociception can be obtained with considerable reductions in the dose of each analgesic. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.