scholarly journals Preoperative Pain Sensitivity and Its Correlation with Postoperative Pain and Analgesic Consumption

2011 ◽  
Vol 114 (2) ◽  
pp. 445-457 ◽  
Author(s):  
Amir Abrishami ◽  
Joshua Chan ◽  
Frances Chung ◽  
Jean Wong ◽  
David S. Warner
Keyword(s):  
Multivariate Analysis ◽  
Postoperative Pain ◽  
Pain Sensitivity ◽  
Pain Perception ◽  
Preoperative Pain ◽  
Thermal Pressure ◽  
Pain Outcomes ◽  
Pain Ratings ◽  
Physical Stimuli ◽  
Pain Stimuli

Pain perception to minor physical stimuli has been hypothesized to be related to subsequent pain ratings after surgery. The objective of this systematic review was to evaluate the correlation between preoperative pain sensitivity and postoperative pain intensity. After a literature search of MEDLINE, EMBASE, and meeting abstracts, we identified 15 studies (n = 948 patients) with univariate and/or multivariate analysis on the topic. In these studies, three types of pain stimuli were applied: thermal, pressure, and electrical pain. The intensity of suprathreshold heat pain (i.e., pain beyond patient threshold) was most consistently shown to correlate with postoperative pain. The most common limitation of the included studies was the method of statistical analysis and lack of multivariate analysis. More research is required to establish the correlation of other pain sensitivity variables with postoperative pain outcomes.

scholarly journals Prediction of Postoperative Pain

2010 ◽  
Vol 112 (6) ◽  
pp. 1494-1502 ◽  
Author(s):  
Mads U. Werner ◽  
Helena N. Mjöbo ◽  
Per R. Nielsen ◽  
Åsa Rudin ◽  
David S. Warner
Keyword(s):  
Postoperative Pain ◽  
Pain Sensitivity ◽  
Pain Perception ◽  
Experimental Pain ◽  
Factor Analyses ◽  
Clinical Value ◽  
Preoperative Pain ◽  
Pain Experience ◽  
Predictive Strength ◽  
Pain Stimuli

Quantitative testing of a patient's basal pain perception before surgery has the potential to be of clinical value if it can accurately predict the magnitude of pain and requirement of analgesics after surgery. This review includes 14 studies that have investigated the correlation between preoperative responses to experimental pain stimuli and clinical postoperative pain and demonstrates that the preoperative pain tests may predict 4-54% of the variance in postoperative pain experience depending on the stimulation methods and the test paradigm used. The predictive strength is much higher than previously reported for single factor analyses of demographics and psychologic factors. In addition, some of these studies indicate that an increase in preoperative pain sensitivity is associated with a high probability of development of sustained postsurgical pain.

Prediction of Postoperative Pain by Preoperative Nociceptive Responses to Heat Stimulation

2004 ◽  
Vol 100 (1) ◽  
pp. 115-119 ◽  
Author(s):  
Mads U. Werner ◽  
Preben Duun ◽  
Henrik Kehlet
Keyword(s):  
Postoperative Pain ◽  
Pain Perception ◽  
Burn Injury ◽  
Area Under The Curve ◽  
Limb Movement ◽  
Preoperative Pain ◽  
Heat Injury ◽  
Nociceptive Responses ◽  
Pain Ratings ◽  
Patients At Risk

Background Despite major advances in the understanding of the neurobiologic mechanisms of pain, the wide variation in acute pain experience has not been well explained. Therefore, the authors investigated the potential of a preoperatively induced heat injury to predict subsequent postoperative pain ratings in patients undergoing knee surgery. Methods Twenty patients were studied. The burn injury was induced 6 days before surgery with a contact thermode (12.5 cm2, 47 degrees C for 7 min). The sensory testing, before and 1 h after the injury, included pain score during induction of the burn, secondary hyperalgesia area, thermal and mechanical pain perception, and pain thresholds. Postoperative analgesia consisted of ibuprofen and acetaminophen. Pain ratings (visual analog scale) at rest and during limb movement were followed for 10 days after surgery. Results The burn injury was associated with development of significant hyperalgesia. There was a significant correlation between preoperative pain ratings during the burn injury and early (0-2 days, area under the curve) and late (3-10 days, area under the curve) postoperative dynamic pain ratings during limb movement. Conclusion The results of this study suggest that the pain response to a preoperative heat injury may be useful in research in predicting the intensity of postoperative pain. These findings may have important implications to identify patients at risk for development of chronic pain and to stratify individuals for investigations of new analgesics.

scholarly journals Predicted Versus Non-Predicted Opioid Administration Using Preoperative Pain Sensitivity in Patients Undergoing Gynecological Surgery: A Randomized-Controlled Trial

2021 ◽  
Vol 10 (4) ◽  
pp. 585
Author(s):  
Sun-Kyung Park ◽  
Hansol Kim ◽  
Seokha Yoo ◽  
Won Ho Kim ◽  
Young-Jin Lim ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Sensitivity ◽  
Control Group ◽  
Gynecological Surgery ◽  
Control Groups ◽  
Preoperative Pain ◽  
Pain Scores ◽  
Pressure Pain Thresholds ◽  
Opioid Administration ◽  
And Control

Individualized administration of opioids based on preoperative pain sensitivity may improve postoperative pain profiles. This study aimed to examine whether a predicted administration of opioids could reduce opioid-related adverse effects after gynecological surgery. Patients were randomized to the predicted group or control group. Participants received a preoperative sensory test to measure pressure pain thresholds. Patients were treated with a higher or lower (15 or 10 μg/mL) dose of fentanyl via intravenous patient-controlled analgesia. The opioid dose was determined according to pain sensitivity in the predicted group, while it was determined regardless of pain sensitivity in the control group. The primary outcome was the incidence of nausea over the first 48 h postoperative period. Secondary outcomes included postoperative pain scores and opioid requirements. There was no difference in the incidence of nausea (40.0% vs. 52.5% in predicted and control groups, respectively; p = 0.191) and postoperative pain scores (3.3 vs. 3.5 in predicted and control groups, respectively; p = 0.691). However, opioid consumptions were lower in the predicted group compared to the control group (median 406.0 vs. 526.5 μg; p = 0.042). This study showed that offering a predicted dose of opioids according to pain sensitivity did not affect the incidence of nausea and pain scores.

scholarly journals Dissociation Between Individual Differences in Self-Reported Pain Intensity and Underlying Brain Activation

2020 ◽  
Author(s):  
M.E. Hoeppli ◽  
H. Nahman-Averbuch ◽  
W.A. Hinkle ◽  
E. Leon ◽  
J. Peugh ◽  
...  
Keyword(s):  
Individual Differences ◽  
Pain Intensity ◽  
Pain Sensitivity ◽  
Pain Perception ◽  
Objective Measure ◽  
Brain Activation ◽  
Individual Experience ◽  
Bold Signal ◽  
Pain Ratings ◽  
Healthy Participants

AbstractPain is a uniquely individual experience. Previous studies have highlighted changes in brain activation and morphology associated with inter- and intra-individual pain perception. In this study we sought to characterize brain mechanisms associated with individual differences in pain in a large sample of healthy participants (N = 101). Pain ratings varied widely across individuals. Moreover, individuals reported changes in pain evoked by small differences in stimulus intensity in a manner congruent with their pain sensitivity, further supporting the utility of subjective reporting as a measure of the true individual experience. However, brain activation related to inter-individual differences in pain was not detected, despite clear sensitivity of the BOLD signal to small differences in noxious stimulus intensities within individuals. These findings raise questions about the utility of fMRI as an objective measure to infer reported pain intensity.

Pain Perception across the Menstrual Cycle Phases in Women with Chronic Pain

2003 ◽  
Vol 96 (1) ◽  
pp. 201-211 ◽  
Author(s):  
Birgitta Hellström ◽  
Ulla Maria Anderberg
Keyword(s):  
Menstrual Cycle ◽  
Pain Sensitivity ◽  
Pain Perception ◽  
Passive Coping ◽  
Menstrual Cycles ◽  
Pain Ratings ◽  
Pain Frequency ◽  
Sensory Processes ◽  
Five Phases ◽  
Phase Differences

The menstrual cycle has been reported to alter pain perception but the patterns differ among studies. It has been reported that estrogens may influence somatic sensory processes. The present aim was to investigate whether the perception of pain varies by phases of the menstrual cycle. 20 women with chronic low pain volunteered to participate and were asked to rate their pain each day during three successive menstrual cycles. The menstrual cycle was divided into four and five phases to be able to compare results. Analysis showed there were phase differences in pain ratings during the menstrual cycle. Regardless of whether the menstrual cycle was divided into four or five phases, women rated pain significantly higher in the menstrual and premenstrual phases than in the midmenstrual and ovulatory phases. This is consistent with other studies showing less pain sensitivity during phases of the menstrual cycle associated with high estrogen. Women with high pain frequency reported more frequency a passive coping style and catastrophizing thoughts.

Hyperalgesia after experimental and work-related sleep restriction

2015 ◽  
Vol 8 (1) ◽  
pp. 52-53
Author(s):  
K.B. Nilsen ◽  
D. Matrea
Keyword(s):  
Pain Sensitivity ◽  
Linear Mixed Model ◽  
Pressure Pain Threshold ◽  
Night Work ◽  
Sleep Restriction ◽  
Heat Pain ◽  
Sleep Study ◽  
Subjective Sleepiness ◽  
Pain Ratings ◽  
Pain Stimuli

AbstractAimsSleep restriction (SR) increases pain sensitivity. The aim of this study was to compare the effects of night work on pain sensitivity with experimental SR.MethodsIn study I 22 healthy volunteers (14 females) and in study II 24 nurses (17 females) received pain stimuli in the laboratory twice; after 2 nights with habitual sleep (study I and II) and after 2 nights of experimental 50% SR (study I) or after 2 nights of work (study II). Order of sleep conditions was randomized. Heat pain at intensity 6/10 (pain-6), the pressure pain threshold (PPT), and subjective sleepiness with Karolinska sleepiness scale (KSS) were assessed. A linear mixed model (LMM) with random intercept and random slope was used. Difference scores were compared between study I and II by independent t-tests (PPT and pain-6) and the Mann–Whitney U test (KSS).ResultsBaseline subjective sleepiness (KSS), PPT or pain-6 ratings did not differ between study I and II (p > 0.47). KSS and heat pain ratings increased after both sleep conditions (p < 0.001), but did not differ between study I and II (p > 0.15). PPT was lower after experimental SR (p = 0.007), but unchanged after night work (p = 0.63), but did not differ between study I and II (p = 0.16).ConclusionsBoth experimental and night work-induced SR leads to comparable increased subjective sleepiness and higher pain ratings to heat pain stimuli. PPT was lower after experimental SR, but was not affected by night work-induced SR.

scholarly journals Predicting Postoperative Pain Based on Preoperative Pain Perception

2010 ◽  
Vol 112 (6) ◽  
pp. 1311-1312 ◽  
Author(s):  
Srinivasa N. Raja ◽  
Troels S. Jensen
Keyword(s):  
Postoperative Pain ◽  
Pain Perception ◽  
Preoperative Pain

scholarly journals Neural indicators of perceptual variability of pain across species

2019 ◽  
Vol 116 (5) ◽  
pp. 1782-1791 ◽  
Author(s):  
L. Hu ◽  
G. D. Iannetti
Keyword(s):  
Pain Sensitivity ◽  
Pain Perception ◽  
Gamma Band ◽  
Neural Responses ◽  
Neural Activities ◽  
Nociceptive Stimulus ◽  
Pain Ratings ◽  
Subjective Pain ◽  
Perceptual Variability ◽  
The Relationship

Individuals exhibit considerable and unpredictable variability in painful percepts in response to the same nociceptive stimulus. Previous work has found neural responses that, while not necessarily responsible for the painful percepts themselves, can still correlate well with intensity of pain perception within a given individual. However, there is no reliable neural response reflecting the variability in pain perception across individuals. Here, we use an electrophysiological approach in humans and rodents to demonstrate that brain oscillations in the gamma band [gamma-band event-related synchronization (γ-ERS)] sampled by central electrodes reliably predict pain sensitivity across individuals. We observed a clear dissociation between the large number of neural measures that reflected subjective pain ratings at within-subject level but not across individuals, and γ-ERS, which reliably distinguished subjective ratings within the same individual but also coded pain sensitivity across different individuals. Importantly, the ability of γ-ERS to track pain sensitivity across individuals was selective because it did not track the between-subject reported intensity of nonpainful but equally salient auditory, visual, and nonnociceptive somatosensory stimuli. These results also demonstrate that graded neural activity related to within-subject variability should be minimized to accurately investigate the relationship between nociceptive-evoked neural activities and pain sensitivity across individuals.

Reduction in Pain Sensitivity from Pharmacological Elevation of Blood Pressure in Persons with Chronically Low Blood Pressure

2009 ◽  
Vol 23 (3) ◽  
pp. 104-112 ◽  
Author(s):  
Stefan Duschek ◽  
Heike Heiss ◽  
Boriana Buechner ◽  
Rainer Schandry
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Pain Sensitivity ◽  
Pain Threshold ◽  
Pain Perception ◽  
Drug Effects ◽  
Pressure Effects ◽  
Double Blind ◽  
Low Blood Pressure ◽  
Present Trial

Recent studies have revealed evidence for increased pain sensitivity in individuals with chronically low blood pressure. The present trial explored whether pain sensitivity can be reduced by pharmacological elevation of blood pressure. Effects of the sympathomimetic midodrine on threshold and tolerance to heat pain were examined in 52 hypotensive persons (mean blood pressure 96/61 mmHg) based on a randomized, placebo-controlled, double-blind design. Heat stimuli were applied to the forearm via a contact thermode. Confounding of drug effects on pain perception with changes in skin temperature, temperature sensitivity, and mood were statistically controlled for. Compared to placebo, higher pain threshold and tolerance, increased blood pressure, as well as reduced heart rate were observed under the sympathomimetic condition. Increases in systolic blood pressure between points of measurement correlated positively with increases in pain threshold and tolerance, and decreases in heart rate were associated with increases in pain threshold. The findings underline the causal role of hypotension in the augmented pain sensitivity related to this condition. Pain reduction as a function of heart rate decrease suggests involvement of a baroreceptor-related mechanism in the pain attrition. The increased proneness of persons with chronic hypotension toward clinical pain is discussed.

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