Dilute lidocaine suppresses ectopic neuropathic discharge in dorsal root ganglia without blocking axonal propagation: a new approach to selective pain control
Ectopic impulse discharge (ectopia) generated in the soma of afferent neurons in dorsal root ganglia (DRG) after nerve injury is believed to be a major contributor to neuropathic pain. The DRG is thus a prime interventional target. The process of electrogenesis (impulse generation) in the DRG is far more sensitive to systemically administered Na+ channel blockers than the process of impulse propagation along sensory axons. It should therefore be possible to selectively suppress DRG ectopia with local application of membrane-stabilizing agents without blocking normal impulse traffic. Results from in vivo electrophysiologica...
Source: Pain - June 26, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Burden of orofacial pain in a socially deprived and culturally diverse area of the United Kingdom
Little is known about the burden and impact of orofacial pain in deprived areas, and whether it mediates the relationship between socioeconomic position and impacts on daily life. We analysed data from a representative sample of 2168 adults, aged 16 to 65 years, from the East London Oral Health Inequality study. Participants completed a validated questionnaire on demographics, socioeconomic position (area deprivation), orofacial pain (by anatomical site) in the past month, and impacts related to oral conditions on daily life. Negative binomial regression models with robust variance estimator were fitted. The prevalence of ...
Source: Pain - June 26, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

The stress regulator FKBP51: a novel and promising druggable target for the treatment of persistent pain states across sexes
It is well established that FKBP51 regulates the stress system by modulating the sensitivity of the glucocorticoid receptor to stress hormones. Recently, we have demonstrated that FKBP51 also drives long-term inflammatory pain states in male mice by modulating glucocorticoid signalling at spinal cord level. Here, we explored the potential of FKBP51 as a new pharmacological target for the treatment of persistent pain across the sexes. First, we demonstrated that FKBP51 regulates long-term pain states of different aetiologies independently of sex. Deletion of FKBP51 reduced the mechanical hypersensitivity seen in joint infla...
Source: Pain - June 26, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Quantitative sensory testing in patients with migraine: a systematic review and meta-analysis
Quantitative sensory testing (QST) is widely used to assess somatosensory function by application of controlled stimuli across a variety of modalities. The aim of the present meta-analysis is to synthesize QST results across a wide array of studies of patients with migraine to identify the QST parameters that are reliably different between patients with migraine and healthy controls. In addition, we aimed to determine whether such differences vary according to stimulus location. A comprehensive literature search (up to January 2017) was conducted, which included studies comparing QST parameters between patients with migrai...
Source: Pain - June 26, 2018 Category: Anesthesiology Tags: Systematic Reviews and Meta-Analysis Source Type: research

Perceived diagnostic uncertainty in pediatric chronic pain
No abstract available (Source: Pain)
Source: Pain - June 26, 2018 Category: Anesthesiology Tags: Topical Review Source Type: research

Alloknesis and hyperknesis—mechanisms, assessment methodology, and clinical implications of itch sensitization
Itch and pain share numerous mechanistic similarities. Patients with chronic itch conditions (for instance atopic dermatitis or neuropathic itch) often experience symptoms such as mechanical alloknesis and hyperknesis. These dysesthesias are analogous to the pain-associated phenomena allodynia and hyperalgesia, which are often observed, for example, in neuropathic pain conditions. Mechanical itch dysesthesias represent abnormal sensory states (caused by neuroplastic changes), wherein considerable itch is evoked, for instance by light cutaneous stimuli such as from clothing (alloknesis), or where increased itch is perceived...
Source: Pain - June 26, 2018 Category: Anesthesiology Tags: Comprehensive Review Source Type: research

A small perceptive study on central poststroke pain
No abstract available (Source: Pain)
Source: Pain - June 26, 2018 Category: Anesthesiology Tags: Commentary Source Type: research

Mechanical perturbation model of temporomandibular joint disorders and assessment of musculature
No abstract available (Source: Pain)
Source: Pain - June 26, 2018 Category: Anesthesiology Tags: Commentary Source Type: research

Reply
No abstract available (Source: Pain)
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

Tired of pain or painfully tired? A reciprocal relationship between chronic pain and fatigue
No abstract available (Source: Pain)
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

Reply
No abstract available (Source: Pain)
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

Recently introduced definition of “nociplastic pain” by the International Association for the Study of Pain needs better formulation
No abstract available (Source: Pain)
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

Repeated touch and needle-prick stimulation in the neonatal period increases the baseline mechanical sensitivity and postinjury hypersensitivity of adult spinal sensory neurons
Noxious stimulation at critical stages of development has long-term consequences on somatosensory processing in later life, but it is not known whether this developmental plasticity is restricted to nociceptive pathways. Here, we investigate the effect of repeated neonatal noxious or innocuous hind paw stimulation on adult spinal dorsal horn cutaneous mechanical sensitivity. Neonatal Sprague-Dawley rats of both sexes received 4 unilateral left hind paw needle pricks (NPs, n = 13) or 4 tactile (cotton swab touch) stimuli, per day (TC, n = 11) for the first 7 days of life. Control pups were left undisturbed (n = 17). When ad...
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Evaluation of different drug classes on transient sciatic nerve injury–depressed marble burying in mice
A great need exists for the identification of new effective analgesics to treat sustained pain. However, most preclinical nociceptive assays measure behavioral responses evoked by noxious stimuli (ie, pain-stimulated behavior), which presents a challenge to distinguish between motor impairing and antinociceptive effects of drugs. Here, we demonstrate that chronic constriction injury (CCI) of the sciatic nerve elicits common pain-stimulated responses (ie, mechanical allodynia and thermal hyperalgesia) as well as reduces marble burying/digging behaviors that occur during the early stages of the neuropathy and resolve within ...
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Use of prescription opioids before and after an operation for chronic pain (lumbar fusion surgery)
Lumbar fusion surgery is usually prompted by chronic back pain, and many patients receive long-term preoperative opioid analgesics. Many expect surgery to eliminate the need for opioids. We sought to determine what fraction of long-term preoperative opioid users discontinue or reduce dosage postoperatively; what fraction of patients with little preoperative use initiate long-term use; and what predicts long-term postoperative use. This retrospective cohort study included 2491 adults undergoing lumbar fusion surgery for degenerative conditions, using Oregon's prescription drug monitoring program to quantify opioid use befor...
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Effectiveness of a healthy lifestyle intervention for chronic low back pain: a randomised controlled trial
We assessed the effectiveness of a 6-month healthy lifestyle intervention, on pain intensity in patients with chronic low back pain who were overweight or obese. We conducted a pragmatic randomised controlled trial, embedded within a cohort multiple randomised controlled trial of patients on a waiting list for outpatient orthopaedic consultation at a tertiary hospital in NSW, Australia. Eligible patients with chronic low back pain (>3 months in duration) and body mass index ≥27 kg/m2 and (Source: Pain)
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Carbenoxolone as a novel therapy for attenuation of cancer-induced bone pain
This study tested the analgesic potential of carbenoxolone, a broad-acting connexin blocker, in a mouse model of cancer-induced bone pain. In addition, a pharmacological approach was used to elucidate the underlying mechanisms using the 2 specific blockers 37,43Gap27 and 43Gap26. Compared with vehicle treatment, chronic systemic administration of 20 or 40 mg/kg carbenoxolone caused a significantly later onset and attenuation of movement-evoked and on-going pain, assessed with limb use and weight bearing, respectively. In addition, the carbenoxolone-treated groups demonstrated a significant delay in time to reach the humane...
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Task interference and distraction efficacy in patients with fibromyalgia: an experimental investigation
In conclusion, current study provides support for contemporary theories claiming that attention modulates the experience of pain and vice versa. However, no evidence was found for an altered attentional processing of pain in patients with FM. Furthermore, results indicate that task interference and distraction efficacy are not just 2 sides of the same coin. (Source: Pain)
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Pain and mortality: mechanisms for a relationship
This study uses a novel approach to test whether lifestyle, health, social, and psychological factors mediate the relationship between pain and mortality. Survival analyses (Cox's proportional hazard modelling and a technique to assess mediation within survival models) were conducted on a large population study of adults aged 50 years or older from the English Longitudinal Study of Ageing (n = 6324). Data collected at wave 2 (2004) were used as baseline and follow-up was until 2012. The relationship between being “often troubled with pain” and mortality was examined. Lifestyle, health, social, and psychological...
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Dyadic differences in friendships of adolescents with chronic pain compared with pain-free peers
A multisite cross-sectional study was conducted to examine dyadic friendship features between adolescents with chronic pain (ACP) and their friends compared with non-pain adolescent friendship dyads and the association of these friendship features with loneliness and depressive symptoms. Participants completed a battery of standardized measures to capture friendship features (friendship quality, closeness, and perceived social support from friends) and indices of social–emotional well-being. Sixty-one same sex friendship dyads (122 adolescents) participated; 30 friendship dyads included an adolescent with chronic pai...
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Pathophysiological mechanisms of neuropathic pain: comparison of sensory phenotypes in patients and human surrogate pain models
As an indirect approach to relate previously identified sensory phenotypes of patients suffering from peripheral neuropathic pain to underlying mechanisms, we used a published sorting algorithm to estimate the prevalence of denervation, peripheral and central sensitization in 657 healthy subjects undergoing experimental models of nerve block (NB) (compression block and topical lidocaine), primary hyperalgesia (PH) (sunburn and topical capsaicin), or secondary hyperalgesia (intradermal capsaicin and electrical high-frequency stimulation), and in 902 patients suffering from neuropathic pain. Some of the data have been previo...
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Injustice perceptions about pain: parent–child discordance is associated with worse functional outcomes
Pain is experienced within and influenced by social environments. For children with chronic pain, the child–parent relationship and parental beliefs about pain are particularly important and may influence pain outcomes. Pain-related injustice perceptions have recently been identified as an important cognitive–emotional factor for children with pain. The current study aimed to better understand the pain-related injustice perceptions of children with chronic pain and their parents. The sample consisted of 253 pediatric chronic pain patients (mean age = 14.1 years, 74% female) presenting to a tertiary pain clinic....
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Monthly vitamin D supplementation, pain, and pattern of analgesic prescription: secondary analysis from the randomized, double-blind, placebo-controlled Vitamin D Assessment study
Observational studies suggest that vitamin D deficiency is associated with higher risk of pain. However, evidence on the effect of vitamin D supplementation on pain is limited and contradictory. The aim of this study was to compare the effect of monthly high-dose vitamin D supplementation on a pain impact questionnaire (PIQ-6) score and prescription of analgesics in the general population. We performed a randomized, double-blind, placebo-controlled trial of 5108 community-dwelling participants, aged 50 to 84 years, who were randomly assigned to receive monthly 100,000-IU capsules of vitamin D3 (n = 2558) or placebo (n = 25...
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Genetic variation in P2RX7 and pain tolerance
P2X7 is a nonselective cation channel activated by extracellular ATP. P2X7 activation contributes to the proinflammatory response to injury or bacterial invasion and mediates apoptosis. Recently, P2X7 function has been linked to chronic inflammatory and neuropathic pain. P2X7 may contribute to pain modulation both by effects on peripheral tissue injury underlying clinical pain states, and through alterations in central nervous system processing, as suggested by animal models. To further test its role in pain sensitivity, we examined whether variation within the P2RX7 gene, which encodes the P2X7 receptor, was associated wi...
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Racial differences in presentations and predictors of acute pain after motor vehicle collision
African Americans experience a greater burden of acute pain than non-Hispanic white individuals across of variety of acute medical conditions, but it is unknown whether this is the case after trauma. We evaluated pain, pain-related characteristics (eg, peritraumatic distress), and analgesic treatment in 2 cohorts of individuals (African American [n = 931] and non-Hispanic white [n = 948]) presenting to the emergency department (ED) after a motor vehicle collision. We performed a propensity-matched analysis (n = 796 in each group) to assess racial differences in acute pain in the ED. In multivariable models conducted within...
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Mixed-methods development of a new patient-reported outcome instrument for chronic low back pain: part 1—the Patient Assessment for Low Back Pain - Symptoms (PAL-S)
We describe the mixed-methods (qualitative and quantitative) development and preliminary validation of the Patient Assessment for Low Back Pain–Symptoms (PAL-S), a patient-reported outcome measure for use in chronic low back pain (cLBP) clinical trials. Qualitative methods (concept elicitation and cognitive interviews) were used to identify and refine symptom concepts and quantitative methods (classical test theory and Rasch measurement theory) were used to evaluate item- and scale-level performance of the measure using an iterative approach. Patients with cLBP participated in concept elicitation interviews (N = 43),...
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Traits associated with central pain augmentation in the Knee Pain In the Community (KPIC) cohort
In conclusion, including representative items within a composite self-report tool might help identify people with centrally augmented knee pain. (Source: Pain)
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Chemotherapy-induced pain is promoted by enhanced spinal adenosine kinase levels through astrocyte-dependent mechanisms
Development of chemotherapy-induced neuropathic pain (CINP) compromises the use of chemotherapy and greatly impacts thousands of lives. Unfortunately, there are no Food and Drug Administration–approved drugs to prevent or treat CINP. Neuropathological changes within CNS, including neuroinflammation and increased neuronal excitability, are driven by alterations in neuro-glia communication; but, the molecular signaling pathways remain largely unexplored. Adenosine is a potent neuroprotective purine nucleoside released to counteract the consequences of these neuropathological changes. Adenosine signaling at its adenosin...
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Heterozygous mutations in GTP-cyclohydrolase-1 reduce BH4 biosynthesis but not pain sensitivity
In conclusion, a reduced concentration of BH4 is not sufficient to alter ongoing pain sensitivity or evoked pain responses. (Source: Pain)
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Pain after surgery
No abstract available (Source: Pain)
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: PAIN Pictured Source Type: research

Hyperpathia: “to be or not to be that is the question”
No abstract available (Source: Pain)
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Topical Review Source Type: research

Implications of parent and child injustice appraisals for child pain and functional outcomes
No abstract available (Source: Pain)
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Commentary Source Type: research

How condition-specific do measures of pain intensity need to be?
No abstract available (Source: Pain)
Source: Pain - May 23, 2018 Category: Anesthesiology Tags: Commentary Source Type: research

Questions and perspectives on involvement of S1PR1 in cancer-induced bone pain and neuroinflammation
No abstract available (Source: Pain)
Source: Pain - April 27, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

Reply
No abstract available (Source: Pain)
Source: Pain - April 27, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

Pronociceptive effects mediated by adenosinergic A2A activity at the nucleus accumbens, but what about the autonomic nervous system?
No abstract available (Source: Pain)
Source: Pain - April 27, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

Reply
No abstract available (Source: Pain)
Source: Pain - April 27, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

Questions raised by the proposed definition of pain: what characterizes the experience of pain and how is subjectivity validated?
No abstract available (Source: Pain)
Source: Pain - April 27, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

Long-term use of naldemedine in the treatment of opioid-induced constipation in patients with chronic noncancer pain: a randomized, double-blind, placebo-controlled phase 3 study
The long-term safety of naldemedine, a peripherally acting µ-opioid receptor antagonist, was evaluated in patients with opioid-induced constipation and chronic noncancer pain in a 52-week, randomized, double-blind, phase 3 study. Eligible adults who could be on a routine laxative regimen were randomized 1:1 to receive once-daily oral naldemedine 0.2 mg (n = 623) or placebo (n = 623). The primary endpoint was summary measures of treatment-emergent adverse events (AEs). Additional endpoints included opioid withdrawal on the Clinical Opiate Withdrawal Scale and the Subjective Opiate Withdrawal Scale, pain intensity on N...
Source: Pain - April 27, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Correlates and importance of neglect-like symptoms in complex regional pain syndrome
Neglect-like symptoms (NLS) are frequently observed in complex regional pain syndrome (CRPS). The clinical meaning of NLS, however, is largely unknown. Therefore, this study sets out to assess the importance of NLS for patient outcome and to explore their clinical correlates. We assessed NLS in a group of 53 patients with CRPS and compared the results to 28 healthy volunteers. To define the origin of the NLS reports, we tested the subjective visual midline, performed a limb-laterality recognition test, and quantitative sensory testing. In addition, psychological and pain assessment scales were completed. Tests were analyze...
Source: Pain - April 27, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Neuroinflammation of the spinal cord and nerve roots in chronic radicular pain patients
Numerous preclinical studies support the role of spinal neuroimmune activation in the pathogenesis of chronic pain, and targeting glia (eg, microglia/astrocyte)- or macrophage-mediated neuroinflammatory responses effectively prevents or reverses the establishment of persistent nocifensive behaviors in laboratory animals. However, thus far, the translation of those findings into novel treatments for clinical use has been hindered by the scarcity of data supporting the role of neuroinflammation in human pain. Here, we show that patients suffering from a common chronic pain disorder (lumbar radiculopathy), compared with healt...
Source: Pain - April 27, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Psychological factors predict an unfavorable pain trajectory after hysterectomy: a prospective cohort study on chronic postsurgical pain
This study identified factors that can be easily screened before and after surgery and are amenable to change through carefully designed timely and tailored interventions for women at risk of an unfavorable PSP trajectory posthysterectomy. (Source: Pain)
Source: Pain - April 27, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Risk of preterm birth following late pregnancy exposure to NSAIDs or COX-2 inhibitors
Pregnant women may take nonsteroidal antiinflammatory drugs (NSAIDs), selective cyclooxygenase (COX)-2 inhibitors, or biological agents to relieve symptoms or manage disease flares in late pregnancy. We aimed to quantify the risk of prematurity associated with late pregnancy exposure to nonselective NSAIDs, selective COX-2 inhibitors, and biological agents. Using data from Quebec Pregnancy Cohort, we performed a population-based cohort study. We included all women who were covered by the Quebec Drug Plan and had a singleton live birth between January 1, 1998 and December 31, 2009. Late pregnancy exposure was defined as hav...
Source: Pain - April 27, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Sensitization of transient receptor potential vanilloid 4 and increasing its endogenous ligand 5,6-epoxyeicosatrienoic acid in rats with monoiodoacetate-induced osteoarthritis
In conclusion, TRPV4 was sensitized in the knee joints of MIA rats through phosphorylation in dorsal root ganglion neurons, along with an increase in the levels of its endogenous ligand 5,6-EET. The analgesic effects of the TRPV4 antagonist in the OA pain model rats suggest that TRPV4 may be a potent target for OA pain relief. (Source: Pain)
Source: Pain - April 27, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Altered connectivity of the right anterior insula drives the pain connectome changes in chronic knee osteoarthritis
Resting-state functional connectivity (FC) has proven a powerful approach to understand the neural underpinnings of chronic pain, reporting altered connectivity in 3 main networks: the default mode network (DMN), central executive network, and the salience network (SN). The interrelation and possible mechanisms of these changes are less well understood in chronic pain. Based on emerging evidence of its role to drive switches between network states, the right anterior insula (rAI, an SN hub) may play a dominant role in network connectivity changes underpinning chronic pain. To test this hypothesis, we used seed-based restin...
Source: Pain - April 27, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Lateralized kappa opioid receptor signaling from the amygdala central nucleus promotes stress-induced functional pain
The response of diffuse noxious inhibitory controls (DNIC) is often decreased, or lost, in stress-related functional pain syndromes. Because the dynorphin/kappa opioid receptor (KOR) pathway is activated by stress, we determined its role in DNIC using a model of stress-induced functional pain. Male, Sprague-Dawley rats were primed for 7 days with systemic morphine resulting in opioid-induced hyperalgesia. Fourteen days after priming, when hyperalgesia was resolved, rats were exposed to environmental stress and DNIC was evaluated by measuring hind paw response threshold to noxious pressure (test stimulus) after capsaicin in...
Source: Pain - April 27, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Spinal protein kinase C/extracellular signal–regulated kinase signal pathway mediates hyperalgesia priming
Chronic pain can be initiated by one or more acute stimulations to sensitize neurons into the primed state. In the primed state, the basal nociceptive thresholds of the animal are normal, but, in response to another hyperalgesic stimulus, the animal develops enhanced and prolonged hyperalgesia. The exact mechanism of how primed state is formed is not completely understood. Here, we showed that spinal protein kinase C (PKC)/extracellular signal–regulated kinase (ERK) signal pathway is required for neuronal plasticity change, hyperalgesic priming formation, and the development of chronic hyperalgesia using acid-induced...
Source: Pain - April 27, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Coregulation of endoplasmic reticulum stress and oxidative stress in neuropathic pain and disinhibition of the spinal nociceptive circuitry
In this study, we examined the cause–effect relationship between ER stress and neuropathic pain using the spinal nerve ligation (SNL) rat model. We showed that ER stress was mutually promotive with oxidative stress during the process. We also tested the hypothesis that spinal sensitization arose from reduced activities of GABA-ergic interneurons and that spinal sensitization was mediated by SDH ER stress. Other important findings in this study including the following: (1) nociceptive behavior was alleviated in SNL rat as long as tauroursodeoxycholic acid injections were repeated to inhibit ER stress; (2) inducing SDH...
Source: Pain - April 27, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Orally active Epac inhibitor reverses mechanical allodynia and loss of intraepidermal nerve fibers in a mouse model of chemotherapy-induced peripheral neuropathy
Chemotherapy-induced peripheral neuropathy (CIPN) is a major side effect of cancer treatment that significantly compromises quality of life of cancer patients and survivors. Identification of targets for pharmacological intervention to prevent or reverse CIPN is needed. We investigated exchange protein regulated by cAMP (Epac) as a potential target. Epacs are cAMP-binding proteins known to play a pivotal role in mechanical allodynia induced by nerve injury and inflammation. We demonstrate that global Epac1-knockout (Epac1−/−) male and female mice are protected against paclitaxel-induced mechanical allodynia. In...
Source: Pain - April 27, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research

Systemic effects of epidural steroid injections for spinal stenosis
This analysis of the lumbar epidural steroid injections for spinal stenosis multicenter randomized controlled trial data identifies the degree of and risk factors for cortisol suppression after epidural steroid injections in older adults with spinal stenosis. Four hundred patients aged 50 years and older with back or leg pain and central lumbar spinal stenosis completed baseline demographic and psychosocial measures. Morning serum cortisol levels were measured at baseline and 3 weeks after initial injection. Patients were randomized to receive epidural injections of either local anesthetic with corticosteroid (n = 200) or ...
Source: Pain - April 27, 2018 Category: Anesthesiology Tags: Research Paper Source Type: research