PAIN�
The injection of dilute formalin results in a stereotyped nociceptive behavioral response. Administration of dextromethorphan (s.c.) but not saline, 30 min prior to intraplantar formalin injection prevents this nociceptive response in a dose-dependent manner. In addition, intraplantar formalin reliably induces c-fos mRNA in the ipsilateral spinal dorsal horn as assessed with quantitative solution...
Recent evidence suggests that hyperalgesia and morphine tolerance, two seemingly unrelated phenomena, have in common certain neural substrates such as activation of the N-methyl-d-aspartate (NMDA) receptor and the subsequent intracellular activation of protein kinase C and nitric oxide. Should common cellular elements be involved in hyperalgesia and morphine tolerance, these cellular and intracellular...
Although the vast majority of patients with cancer pain receive effective analgesia from standard therapy, a few patients, particularly those with neuropathic pain, continue to experience severe pain despite large doses of systemic or intraspinal opioids. Animal studies suggest intraspinal α 2 -adrenergic agonists may be effective in such cases. Eighty-five patients with severe cancer pain...
In a rat model of artificial ureteral calculosis, the aim of the study was to characterize the behavioural manifestations of direct visceral pain and to evaluate the relationship between number, duration and complexity of the visceral episodes and the extent of referred lumbar muscular hyperalgesia. As evidenced by non-stop video-tape recordings over 4-14 days, almost 98% of stone-implanted rats showed...
Amitriptyline and cyclobenzaprine have shown some efficacy in treatment of the generalised pain syndrome, fibromyalgia. The aim of this study was to examine the efficacy of antidepressant dosages of the serotonin re-uptake inhibitor citalopram in fibromyalgia. In a double-blind, placebo-controlled study 22 patients with fibromyalgia were randomized to treatment with citalopram for 4 weeks at a dosage...
Twenty-six patients with severe pain associated with cancer were entered into a study where they were required to take morphine mixture for 7 days. Prior to this, their morphine dose had been optimised to provide the most favourable balance between pain relief and side effects. After 6 days of taking their optimised morphine dose at 4-hourly intervals, the patients were admitted to the Pain Management...
The development of tolerance to the analgesic effects of morphine as well as morphine dependence were greatly reduced by co-administration with morphine of GM1 ganglioside, a substance reported to block the translocation of protein kinase C (PKC) from cytosol to membrane of neurons. Rats made tolerant to intrathecal administration of morphine showed increased membrane-bound PKC in the superficial...
A treatment outcome study was conducted to compare the efficacy of cognitive behavior therapy (CBT) versus general anesthesia in alleviating the distress of 18 pediatric cancer patients (ages: 3-12 years) undergoing bone marrow aspirations (BMAs). CBT and short-acting mask anesthesia were delivered within a repeated-measures counterbalance design. Results indicated that children exhibited more behavioral...
This study evaluated the multidimensional structure of affective verbal descriptors and investigated individual differences in the scaling of the descriptors. Patients with chronic low back pain, chronic headache and rheumatoid arthritis (25 per group) and 25 control subjects, matched for age and sex, made similarity judgements of a set of 12 verbal descriptors, e.g., awful, miserable. They also...
Research has indicated that the way individuals cope with pain may influence pain, and physical and psychological adjustment. The present study assessed the relationship between coping strategy use and adjustment in amputees with phantom limb pain (PLP). Coping strategies were measured using the Coping Strategies Questionnaire (CSQ) and their relationship with adjustment was examined using both...
A double-blind multidose trial of the addition of ketamine (0-40 mg, i.m., 8 times per day) to intramuscular morphine therapy was undertaken in a 61-year-old man with chronic back pain related to osteoporosis who had received inadequate pain relief from anterior interbody fusion, dorsal column stimulation and morphine alone. The patient reported only mild side effects. Nausea, tiredness and well-being...
To assess the efficacy of 4% topical lidocaine in spheno-palatine blocks, a randomized controlled trial was carried out on patients with chronic muscle pain syndromes. Sixty-one patients (42 with fibromyalgia (FM) and 19 with myofascial pain syndrome (MPS)) completed the trial. Outcome measures included pain intensity, a daily pain diary, headache frequency, sensitivity to pressure using a dolorimeter,...
The objective of this work was to investigate the pattern of pain threshold (PT) alterations in paraspinal soft tissues as related to inflamed joints in patients with juvenile chronic arthritis (JCA). A pressure algometer was used in JCA patients with inflamed knee(s) (n = 16), with inflamed ankle(s) (n = 17), and in healthy controls (n = 69), all aged 6-17 years. Local pressure was applied to the...
Tramadol hydrochloride is a synthetic μ-opioid agonist with additional monoaminergic activity. Tramadol's analgesic effect has been equated with that of pethidine, with a more favourable side-effect profile. Tramadol has been the most-selling prescription analgesic in Germany for several years, and it is now available in many other European countries, but still there is a lack of adequately controlled...
On the premises of clinical studies, a possible contribution of oxygen radicals has been considered to the development of inflammatory pain and hyperalgesia. In a rat skin-saphenous nerve preparation using standard teased-fiber techniques (n = 57) hydrogen peroxide (1 mM, 10 mM and 50 mM) was applied in aqueous solution to cutaneous nerve endings of unmyelinated nociceptive afferents. Superoxide...
The McGill Pain Questionnaire (MPQ) (Melzack 1975) is an important assessment tool for multidimensional pain measurement in both clinical practice and research. Despite widespread acceptance, empirical analyses have not consistently verified the 3 a-priori factors that guided the subclass construction of the Pain Rating Index (PRI) of the MPQ. This study compared the a-priori model with 2 qualitatively...