European journal of pain : EJP
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After intramuscular (m. tibialis anterior) injection of three different algogenic substances, the pain intensity was continuously scored on a visual analogue scale (VAS) in eight volunteers. The subject drew the distribution of the local and referred pain areas on a map. Four times within the first hour after injection, the pressure pain-thresholds (PPTs) and supra pressure-pain thresholds were assessed at the injection point, 2 cm distal from the injection site, at the arm, and at the contralateral leg. ⋯ We conclude that under the present experimental conditions, BKN and 5-HT can produce low levels of muscle pain after intramuscular injection. In the used concentrations, however, BKN, 5-HT, and SP did not generate cutaneous or muscular hyperalgesia. Copyright 1999 European Federation of Chapters of the International Association for the Study of Pain.
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A need to consider possible gender differences in pain research has been recognized by researchers during the last decades. As part of a psychometric evaluation of the Swedish version of the Multidimensional Pain Inventory (MPI-S), we performed gender-differentiated analyses of the internal consistency, validity and sensitivity to change of the MPI-S in a sample of 235 individuals (129 females, 106 males) suffering from long-term non-specific pain from the lower back and/or neck region. The construct validation and sensitivity analyses were performed by using validated self-report measures and direct observational assessment techniques as external constructs. ⋯ Altogether, the results showed a similar pattern across gender, although some divergences were detected, such as the substantially weaker negative correlation between perceived supportive behaviour from significant others and punishing responses for males compared to females. In conclusion, we recommend the use of sections 1 and 2 of the MPI-S as a psychometrically evaluated and comprehensive instrument in the assessment of individuals suffering from chronic non-specific low back pain or neck pain. Copyright 1999 European Federation of Chapters of the International Association for the Study of Pain.
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Peripheral nerve injury may lead to neuropathic pain that has been considered unresponsive to opioids. In animal models of neuropathic pain, there are previous data of both increased and decreased effect of opioids, but only limited information of the long-term effects of opioid treatment on the development of the symptoms of neuropathy. The possibility of preventing the development of signs of neuropathy with either a single pre-injury injection or chronic postinjury administration of morphine was studied in rats with unilateral peripheral neuropathy due to tight ligation of the L5 and L6 spinal nerves. ⋯ No autotomy, signs of distress, altered social behaviour or morphine withdrawal was seen in any of the rats. The fact that neuropathic pain-like symptoms were not attenuated by any of the treatments studied could indicate that neither premedication nor postoperative pain management with systemic morphine is effective in preventing postoperative neuropathic pain. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.
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The transdermal therapeutic system (TTS) for fentanyl is a drug-delivery system for use in patients with chronic pain who require an opioid analgesic. A multicentre, randomized, double-blind, placebo-controlled study was performed to evaluate the efficacy and safety of TTS-fentanyl as an analgesic for chronic cancer pain. One hundred and thirty-eight patients entered a 15-day dose-titration period, followed by a 9-day double-blind period (95 patients) with TTS-fentanyl or placebo. ⋯ Due to an unexpectedly high placebo response it was not possible to demonstrate fentanyl to be statistically superior to placebo. This may reflect the practical difficulties of performing clinical trials in cancer patients with great inter-individual variability. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.
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The aim of this investigation was to study the effect of suggestions of hypnotic analgesia on spinal pain transmission and processing. Pain intensity and amplitude of nociceptive withdrawal reflexes to electrical stimuli were measured in 10 high- and 10 low-hypnotizable subjects during two sessions taking place at least 24 h apart under five conditions of: (1) pre-hypnosis; (2) neutral hypnotic relaxation; (3) suggestions of hypnotic analgesia; (4) suggestions of hypnotic analgesia after injections of either naloxone (1 ml, 1 mg/ml) or saline (1 ml) under double-blinded conditions; and (5) post-hypnosis. The conditions of naloxone or saline were allocated at random to either Day 1 or Day 2 in a double-blinded fashion. ⋯ These results suggest that the effect of naloxone was related to the greater stimulus intensities needed to elicit a reflex in the high-hypnotizable group, rather than to hypnosis or hypnotic susceptibility in itself. It is unclear why greater stimulus intensities were needed in high-hypnotizable subjects and further studies are needed. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.