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Journal Journal of Pain Research

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Journal of Pain Research; doi:10.2147/jpr

Abstract:An international, peer reviewed, open access, online journal that welcomes laboratory and clinical findings in the fields of pain research and the prevention and management of pain. Original research, reviews, symposium reports, hypothesis formation and commentaries are all considered for publication.
Michael Semyonov, Ekaterina Fedorina, Julia Grinshpun, Michael Dubilet, Yael Refaely, Leonid Ruderman, Leonid Koyfman, Michael Friger, Alexander Zlotnik, Moti Klein, et al.
Journal of Pain Research, Volume 12, pp 953-960; doi:10.2147/JPR.S191263

Abstract:Patients who undergo surgical procedures that impair the integrity of the chest wall frequently experience extremely severe postoperative pain. Opiates and weaker analgesics, such as nonsteroidal anti-inflammatory drugs (NSAIDs), are not sufficiently effective in achieving control of severe pain and might cause respiratory and gastrointestinal complications. In the past decade, there has been an increased interest in the use of regional nerve blocks for post-thoracoscopy and post-thoracotomy analgesia. This is a prospective, randomized, double-blind and single-center study. We recruited 104 patients who underwent elective thoracoscopy. Prior to surgery, the participating patients were randomized into one of two study groups: Group 1- the “standard control group” that received standard postoperative pain control with intravenous opioids, NSAIDs and acetaminophen (paracetamol) and Group 2- the “block group” that was treated by ultrasound-guided serratus anterior plane (SAP) block (a single injection of 0.25% bupivacaine hydrochloride 2 mg/kg plus dexamethasone 8 mg) with standard postoperative pain control regimen. We compared the clinical, laboratory, and postoperative pain assessment data of both groups. Patients in the SAP block Group 2 reported significantly lower levels of pain after thoracic surgery as assessed by their visual analog scale scores, as compared to the patients in the standard pain control Group 1 (P<0.001). The total dosage of morphine and tramadol required for pain relief during the first hours after surgery was significantly lower in the patients who received SAP block. Also, the incidence of vomiting after surgery was significantly lower among the patients who received SAP block than among the patients who received standard pain control. The results of the present study suggest that SAP block is an effective adjuvant treatment option for post-thoracic surgery analgesia. Compared to the current methods used for post-thoracic surgery pain relief, SAP block has some significant merits, particularly its ease of use and its low potential for side effects.
Eugene R Viscusi, Franck Skobieranda, David G Soergel, Emily Cook, David A Burt, Neil Singla
Journal of Pain Research, Volume 12, pp 927-943; doi:10.2147/JPR.S171013

Abstract:Oliceridine is a novel G protein-biased µ-opioid receptor agonist designed to provide intravenous (IV) analgesia with a lower risk of opioid-related adverse events (ORAEs) than conventional opioids. APOLLO-1 (NCT02815709) was a phase III, double-blind, randomized trial in patients with moderate-to-severe pain following bunionectomy. Patients received a loading dose of either placebo, oliceridine (1.5 mg), or morphine (4 mg), followed by demand doses via patient-controlled analgesia (0.1, 0.35, or 0.5 mg oliceridine, 1 mg morphine, or placebo). The primary endpoint compared the proportion of treatment responders through 48 hours for oliceridine regimens and placebo. Secondary outcomes included a composite measure of respiratory safety burden (RSB, representing the cumulative duration of respiratory safety events) and the proportion of treatment responders vs morphine. Effective analgesia was observed for all oliceridine regimens, with responder rates of 50%, 62%, and 65.8% in the 0.1 mg, 0.35 mg, and 0.5 mg regimens, respectively (all P<0.0001 vs placebo [15.2%]; 0.35 mg and 0.5 mg non-inferior to morphine). RSB showed a dose-dependent increase across oliceridine regimens (mean hours [SD]: 0.1 mg: 0.04 [0.33]; 0.35 mg: 0.28 [1.11]; 0.5 mg: 0.8 [3.33]; placebo: 0 [0]), but none were statistically different from morphine (1.1 [3.03]). Gastrointestinal adverse events also increased in a dose-dependent manner in oliceridine regimens (0.1 mg: 40.8%; 0.35 mg: 59.5%; 0.5 mg: 70.9%; placebo: 24.1%; morphine: 72.4%). The odds ratio for rescue antiemetic use was significantly lower for oliceridine regimens compared to morphine (P<0.05). Oliceridine is a novel and effective IV analgesic providing rapid analgesia for the relief of moderate-to-severe acute postoperative pain compared to placebo. Additionally, it has a favorable safety and tolerability profile with regard to respiratory and gastrointestinal adverse effects compared to morphine, and may provide a new treatment option for patients with moderate-to-severe postoperative pain where an IV opioid is required.
Jens Agerström, Kent Stening, Olof Axman
Journal of Pain Research, Volume 12, pp 961-968; doi:10.2147/JPR.S194114

Abstract:The ability to traverse psychological distance by going beyond the experienced reality of the self, here and now, is fundamental for effective human functioning. Yet, little is known about how physical pain affects transcendence of psychological distance. Using a construal level theory framework of psychological distance, the current research examines the hypothesis that pain impairs people’s ability to traverse any kind of psychological distance whether it be temporal, social, and spatial distance, or the hypothetical. Using the cold pressor test, 151 participants participated in an experiment where they were either induced with acute pain (treatment group) or no pain (control group) while completing a battery of questions measuring to what extent their current thoughts were transcending psychological distance. The results were largely consistent with the hypothesis. Relative to the control group, pain induced participants showed significantly less transcendence of past temporal distance, social distance, spatial distance, and the hypothetical. Furthermore, greater self-reported pain intensity was significantly associated with less transcendence of temporal (past and future), social, and spatial distance. Physical pain impairs the ability to traverse psychological distance. The research has practical implications for the pain clinic and for pain-afflicted individuals in everyday life.
Carla Galvani, Paola Caramaschi, Paolo Mura, Antonella Paladini, Alba Piroli, Elisa Arnaudo, Lucia De Franceschi, Maurizio Evangelista, Alice Pari, Giovanna Ongaro, et al.
Journal of Pain Research, Volume 12, pp 951-951; doi:10.2147/JPR.S205022

Abstract:Postural counseling represents a novel option in pain management of fibromyalgia patients [Erratum] Galvani C, Caramaschi P, Mura P, et al. J Pain Res. 2019;12: 327–337. On page 336, the wrong author name was given in part of the author contributions section. The correct details follow. Author contributions P Caramaschi, D Biasi and A Carletto were the rheumatologists in charge of FM patients, and they collected and analyzed the patients’ data and wrote the paper. C Galvani and G Ongaro were the counselor physiotherapists involved in FM treatment, collected illness narratives, analyzed the data and wrote the paper. L De Franceschi, P Mura, M Evangelista, A Paladini and G Finco analyzed the data and wrote the paper. A Ciannameo, A Pari, and E Arnaudo carried out the interviews, analyzed the data and wrote the paper. A Piroli and G Varrassi wrote and reviewed the paper and A Piroli also approved the text. All authors contributed toward data analysis, drafting and critically revising the paper, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.Read the original article
Björn Gerdle, Sophia Åkerblom, Gunilla Brodda Jansen, Paul Enthoven, Malin Ernberg, Huan-Ji Dong, Britt-Marie Stålnacke, Björn O Äng, Katja Boersma, Björn Äng
Journal of Pain Research, Volume 12, pp 891-908; doi:10.2147/JPR.S190003

Abstract:Chronic pain patients frequently suffer from psychological symptoms. There is no consensus concerning the prevalence of severe anxiety and depressive symptoms and the strength of the associations between pain intensity and psychological distress. Although an important aspect of the clinical picture is understanding how the pain condition impacts life, little is known about the relative importance of pain and psychological symptoms for individual’s life impact. The aims of this study were to identify subgroups of pain patients; to analyze if pain, psychological distress, and life impact variables influence subgrouping; and to investigate how patients in the subgroups benefit from treatments. Background variables, pain aspects (intensity/severity and spreading), psychological distress (depressive and anxiety symptoms), and two life impact variables (pain interference and perceived life control) were obtained from the Swedish Quality Registry for Pain Rehabilitation for chronic pain patients and analyzed mainly using advanced multivariate methods. Based on >35,000 patients, 35%–40% had severe anxiety or depressive symptoms. Severe psychological distress was associated with being born outside Europe (21%–24% vs 6%–8% in the category without psychological distress) and low education level (20.7%–20.8% vs 26%–27% in the category without psychological distress). Dose relationships existed between the two psychological distress variables and pain aspects, but the explained variances were generally low. Pain intensity/severity and the two psychological distress variables were significantly associated (R2=0.40–0.48; P>0.001) with the two life impact variables (pain interference and life control). Two subgroups of patients were identified at baseline (subgroup 1: n=15,901–16,119; subgroup 2: n=20,690–20,981) and the subgroup with the worst situation regarding all variables participated less in an MMRP (51% vs 58%, P<0.001) but showed the largest improvements in outcomes. The results emphasize the need to assess both pain and psychological distress and not take for granted that pain involves high psychological stress in the individual case. Not all patients benefit from MMRP. A better matching between common clinical pictures and the content of MMRPs may help improve results. We only partly found support for treatment resistance in patients with psychological distress burden.
Francis Sahngun Nahm, Sang-Soep Nahm, Woong Ki Han, Ho Young Gil, Eunjoo Choi, Pyung Bok Lee
Journal of Pain Research, Volume 12, pp 909-914; doi:10.2147/JPR.S166270

Abstract:Complex regional pain syndrome (CRPS) is a rare but refractory pain disorder. Recent advanced information retrieval studies using text-mining and network analysis have suggested nuclear factor kappa B (NFκB) as a possible central mediator of CRPS. The brain is also known to play important roles in CRPS. The aim of this study was to evaluate changes in cerebral NFκB in rats with CRPS. The chronic post-ischemia perfusion (CPIP) model was used as the CRPS animal model. O-rings were applied to the left hind paws of the rats. The rats were categorized into three groups according to the results of behavioral tests: the CPIP-positive (A) group, the CPIP-negative (B) group, and the control (C) group. Three weeks after the CPIP procedure, the right cerebrums of the animals were harvested to measure NFκB levels using an ELISA. Animals in group A had significantly decreased mechanical pain thresholds (P<0.01) and significantly increased cerebral NFκB when compared to those in groups B and C (P=0.024). This finding indicates that peripheral injury increases cerebral NFκB levels and implies that minor peripheral injury can lead to the activation of pain-related cerebral processes in CRPS.
Xiaoning Li, Shuhong Yang, Liang Wang, Peng Liu, Shuang Zhao, Huizhou Li, Yuqing Jiang, Yuexian Guo, Xiuli Wang
Journal of Pain Research, Volume 12, pp 879-890; doi:10.2147/JPR.S185873

Abstract:Phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) is one of the essential signaling pathways for the development and maintenance of neuropathic pain. To investigate the effect of resveratrol (RES) on paclitaxel-induced neuropathic pain in rats and elucidate the underlying molecular mechanisms. Male Sprague Dawley rats were randomly divided into seven groups (n=10/group): Group C, Group P, Group R, Group R+P, Group LY + R+P, Group LY (the specific inhibitor of PI3K), Group E (the specific inhibitor of sirtuin 1 [SIRT1]). Paw withdrawal mechanical threshold (PWT) and thermal withdrawal latency (TWL) were recorded. Mitochondrial histomorphology was performed by transmission electron microscope. PI3K, p-Akt, and t-Akt expressions were tested using immunohistochemistry. Western blot was used to detect p-Akt, t-Akt, SIRT1, and PGC1α expressions. The apoptosis in the striatum, spinal dorsal horns (SDH), and dorsal root ganglions (DRG) tissues was assayed by TUNEL. ELISA was used to detect the contents of IL-β, IL-10, malondialdehyde (MDA), and superoxide dismutase (SOD) in striatum, SDH, and DRG tissues. Compared to the control group, PWT and TWL in the P and LY +R+P groups were significantly decreased on 8th and 14th day after paclitaxel administration (P<0.05). The expressions of p-Akt, SIRT1, and PGC1α were decreased in paclitaxel-induced neuropathic rats; however, the expressions of p-Akt, SIRT1, and PGC1α were significantly increased after RES treatment (P<0.05). Furthermore, the expression of p-Akt was decreased by LY294002 (P<0.05), and amount of SIRT1 and PGC1α expression was inhibited by EX-527 (P<0.05). The t-Akt level was not significantly changed in all groups. RES prevented paclitaxel-induced mitochondrial damage by PI3K/Akt. RES improves the pain symptoms of paclitaxel neuralgia rats by increasing the IL-10 and decreasing the expression of IL-1β. RES increases the SOD and reduces the MDA. RES reduces apoptosis by SIRT1/PGC1α signal pathway. Our results suggest that RES may inhibit paclitaxel-induced neuropathic pain via PI3K/Akt and SIRT1/PGC1α pathways.
Sayed Wahezi, Salah Eldin Mohamed, Andrew Lederman, Amanda P Beck
Journal of Pain Research, Volume 12, pp 1033-1039; doi:10.2147/jpr.s181038

Abstract:Aggregation properties of triamcinolone acetonide injection in human serum: considerations when performing epidural steroid injections
Leslie Tive, Alfonso E Bello, David Radin, Thomas J Schnitzer, Ha Nguyen, Mark T Brown, Christine R West
Journal of Pain Research, Volume 12, pp 975-995; doi:10.2147/jpr.s191297

Abstract:Pooled analysis of tanezumab efficacy and safety with subgroup analyses of phase III clinical trials in patients with osteoarthritis pain of the knee or hip
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