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 47,337 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effect of the application to the skin of the chemical irritant mustard oil on the size and responsiveness of the cutaneous mechanoreceptive fields of 32 lumbar dorsal horn neurons has been examined in the adult decerebrate, spinal rat. Mustard oil placed on a small region of skin outside the mechanoreceptive firing zone produced a brief (185 +/- 35 sec, SEM) discharge of action potentials in 17 neurons and, in 23 cells, a prolonged increase of the response to a standard low- or high-intensity mechanical stimulus applied to the firing zone of the receptive field. This increase was shown, in 6 intracellularly recorded cells, to be due to a significantly increased depolarization in response to the stimuli. An expansion of the mechanoreceptive firing zones that peaked at 26 +/- 3.7 min was seen in 21 cells. While 6 of 8 nociceptive-specific neurons and 11 of 18 multireceptive neurons showed such an expansion, it did not occur in the 6 cells with low-threshold-only receptive fields. The expansion of the firing zones in 4 intracellularly recorded cells was found to be due to an increased amplitude of the EPSPs evoked by stimuli applied to what had initially been low probability firing fringes (Woolf and King, 1989) outside the firing zones, so that subthreshold responses became suprathreshold after application of the mustard oil. In 4 of 8 nociceptive-specific cells, the mechanical threshold in the firing zone became reduced to innocuous levels after application of the mustard oil. The demonstration of the capacity of a relatively brief afferent barrage of chemosensitive nociceptors to produce an increase in the spatial extent of the cutaneous receptive fields of dorsal horn neurons, amplify their responsiveness, and reduce their thresholds has implications both for the pathogenesis of postinjury pain hypersensitivity phenomena and for receptive field plasticity in the somatosensory system.
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PMID:Dynamic alterations in the cutaneous mechanoreceptive fields of dorsal horn neurons in the rat spinal cord. 238 84

The initial effectiveness as well as the temporal stability of the effect of cervical spinal manipulation with respect to the amelioration of goniometrically verified cervical lateral-flexion passive end-range asymmetry was examined. Responses of two groups of pain-free subjects were compared: a) those exhibiting end-range asymmetries of greater than 10 degrees who, in addition, had suffered previous neck trauma, and; b) those who happened to exhibit end-range asymmetries of greater than 10 degrees but who had no history of prior neck trauma. All subjects received a single lower cervical adjustment delivered to the side of most-restricted end-range, and goniometric reassessments were performed 30 min, 4 hr, and 48 hr following the adjustment. A dramatic amelioration of asymmetry was observed in both groups at 30 min and 4 hr postmanipulation. Furthermore, the magnitudes of these short-term effects were similar for the two groups. However, by 24 hours, a difference in the temporal responses of the groups had become readily apparent. By 48 hours, the difference was even more striking; whereas 14 of 16 of the subjects with no previous neck trauma continued to exhibit asymmetries of less than 10 degrees (mean +/- SEM = 3.8 +/- 1.0 degrees), 12 of the 16 subjects with previous neck trauma had regained asymmetries of greater than 10 degrees (mean +/- SEM = 11.4 +/- 1.7 degrees). These results indicate that among asymptomatic (pain-free) individuals, the mere presence of passive end-range asymmetry as well as the magnitude of the short-term ameliorative effect of cervical manipulation do not distinguish these two categories of subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Time course considerations for the effects of unilateral lower cervical adjustments with respect to the amelioration of cervical lateral-flexion passive end-range asymmetry. 239 46

Cerebrospinal fluid (CSF) samples from 18 female patients with fibromyalgia (fibrositis syndrome) were analyzed for beta-endorphin. The mean CSF level of beta-endorphin was 20.7 +/- 0.7 fmol/ml in the patients compared to 20.5 +/- 2.0 fmol/ml (mean +/- SEM) in healthy controls (p greater than 0.05). Thus, patients with fibromyalgia (fibrositis syndrome) seem to have normal CSF levels of the pain modulatory neuropeptide beta-endorphin.
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PMID:Cerebrospinal fluid levels of beta-endorphin in patients with fibromyalgia (fibrositis syndrome). 246 20

The cerebrospinal fluid (CSF) levels of calcitonin gene related peptide (CGRP) were 0.94 +/- 0.06 fmol/ml (mean +/- SEM), of substance P, 35.1 +/- 3.2 fmol/ml and of substance P (1-7), 10.8 +/- 1.2 fmol/ml, as measured by radioimmunoassay in 26 female patients with fibromyalgia. No correlation was found between the levels of CGRP and the substance P and substance P (1-7) levels (r = 0.316, p = 0.14). Our results show that the anatomical coexistence of pain related neuropeptides in neurons is not necessarily reflected by the levels of these peptides measured in the CSF. The presence of CGRP in the CSF could be important since it can enhance the nociceptive activity of tachykinins. This may be of importance in the pathogenesis of pain in fibromyalgia.
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PMID:Modulation of pain in fibromyalgia (fibrositis syndrome): cerebrospinal fluid (CSF) investigation of pain related neuropeptides with special reference to calcitonin gene related peptide (CGRP). 248 42

We have examined the effects of extradural clonidine 150 micrograms or morphine 4 mg on postoperative pain, stress responses, cardiopulmonary function and motor and sensory block in a double-blind, randomized study in 20 patients undergoing hysterectomy with general anaesthesia. Observations were made for 6 h after each patient's first request for analgesia. Clonidine provided greater pain relief than morphine only for the first 2 h of observation (P less than 0.001). Plasma cortisol concentrations decreased to a greater extent (P less than 0.05) with morphine, while plasma glucose concentration increased by a similar extent in both groups. After clonidine, mean arterial pressure decreased from 100 (SEM 3) mm Hg to 70 (3) mm Hg (P less than 0.05), but there was no change after morphine. There were no significant changes in heart rate, pulmonary function (FEV1), motor function or sensory analgesia to touch, temperature and pinprick in both groups. Additional systemic opioids were required by five and six patients in the clonidine and morphine groups, respectively.
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PMID:Comparison of the effects of extradural clonidine with those of morphine on postoperative pain, stress responses, cardiopulmonary function and motor and sensory block. 251 58

In a pilot study, defibrotide was administered to 22 patients with arterial occlusive disease of the lower limbs (mean age 59 years; range 48-71 years), of whom 12 were Fontaine 2nd stage and 10 Fontaine 3rd stage. In the first group, treatment enabled significant improvement in the walking distance (580 +/- 95 vs 220 +/- 65 m; M +/- SD; p less than 0.001), even 15 days after discontinuation of therapy (445 +/- 110 m; p less than 0.05). In 3rd stage patients, treatment caused reasonable reduction of pain, with elimination of resting pain in 4 patients. Both groups underwent no modification of Doppler velocimetry and Winsor index, while photoplethysmography in 8 patients at 2nd- and in 3 patients at 3rd-stage showed improvement at the end of treatment. There were no modifications of hepatic, renal, hemopoietic and hemocoagulative functions. Beta-thromboglobulin showed a statistically significant reduction (62 +/- 10 vs 116 +/- 18 ng/ml; M +/- SEM; p less than 0.001), from 2 weeks after the first dose until 15 days after discontinuation of therapy. Defibrotide proved particularly efficacious in Fontaine 2nd-stage patients, showing its suitability for treating the stages of occlusive atherosclerotic disease at which collateral circulation can still be activated.
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PMID:Defibrotide and peripheral obliterative arterial disease: preliminary data. 253 80

The purpose of this study was to evaluate the role of endogenous opiates in modulating physical performance during dynamic exercise in conscious man. The plasma concentration of beta-endorphin (BEP) and of adrenocorticotropic hormone (ACTH) along with muscle pain (McGuill Pain Questionnaire) were assessed in 17 trained, male runners before and after running the longest possible distance within 12 min (i.e., the Cooper test). Each runner participated twice in the test (double-blind cross-over design), with a 1-week interval--with or without an injection of the opiate antagonist naloxone (0.8 mg i.v.). The average (SEM) distance reached was 3,198 (45) m in the naloxone test and 3,240 (38) m in the placebo test. The BEP increased significantly during the tests by a factor of 4.1 on naloxone and by 2.8 on placebo (from the normal resting averages of 1.7 and 2.1 pmol/l, respectively). The ACTH also increased significantly by a factor of 2.0 on naloxone and 2.5 on placebo (from the normal resting averages of 19.3 and 16.8 pmol/l, respectively). There were no significant differences between the naloxone and the placebo test with respect to the increments of BEP or ACTH by exercise. However, the perception of muscle pain was enhanced with naloxone. The increased perception of pain did not decrease the athletes ability to perform in terms of the distance run. We conclude that endogenous opiates are involved in the perception of pain associated with exhaustive exercise and may subserve psychological rather than physiological functions during exercise.
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PMID:Opioid involvement in the perception of pain due to endurance exercise in trained man. 254 82

Six groups of ten women each in active labor at term had epidural catheters placed in the usual manner and received a 3 mL test dose of 2% lidocaine with epinephrine. Groups 1-6 received, respectively, 5, 10, 20, 30, 40 and 50 micrograms of sufentanil diluted to 10 mL with normal saline. Significantly effective analgesia was provided at all sufentanil doses studied, with pain scores decreasing from 8.1 +/- 0.2 at baseline to 2.9 +/- 0.3 at 10 minutes and 1.1 +/- 0.2 at 30 minutes (mean +/- SEM, average for all groups). The duration of analgesia showed a significant (p less than 0.05) relation to sufentanil dose, increasing from 79.1 +/- 11.3 minutes (5-micrograms group) to 137.8 +/- 17.2 minutes (50-micrograms group). There were no serious maternal side effects, although ten patients developed pruritus, four became dizzy, two experienced mild sedation, and one had transient hypotension. No neonatal side effects occurred. Maternal serum sufentanil levels remained below the sensitivity of the assay, or 0.1 ng/ml.
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PMID:Epidural sufentanil for analgesia for labor and delivery. 257 52

Experimental data and anecdotal clinical observations have shown that clonidine, an alpha 2-agonist, has a marked analgesic effect. We investigated clonidine-induced analgesia in response to nociceptive stimuli. On 2 different days 7 normal volunteers received either placebo or clonidine (200 micrograms) orally according to a cross-over, double-blind, randomized, placebo-controlled design. Analgesia was assessed by measurement of the subjective (VAS) and objective (R III reflex) pain thresholds. A close correlation was observed between subjective and objective pain thresholds (r = 0.88, y = 0.2 + 1.2 x). Clonidine increased the objective threshold by 21% (+6.2 mA, SEM 2.4) and the subjective threshold by 10% (+2.4 mA, SEM 1.3). Drug effect was rapid (peak between 90 and 120 min) and overall analgesia lasted up to 4 hours. Side effects were a moderate fall in blood pressure, sedation and dryness of the mouth. A single oral dose of clonidine induces significant analgesia. These results suggest that clonidine is potentially a worthwhile drug for pain treatment which deserves further clinical investigation.
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PMID:[Analgesic effects of an oral dose of clonidine]. 261 77

We studied the effects of EMLA on tourniquet pain in 10 healthy male volunteers. The tourniquet inflation time which was tolerated was significantly longer with EMLA (46.4 (SEM 3.5) min) compared with placebo (37.5 (2.7) min) (P less than 0.05). Linear analogue pain scores increased in both groups over the study period, but were significantly less in the EMLA group at 40 min (P less than 0.05). We conclude that tourniquet pain has a significant cutaneous component.
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PMID:Effect of a eutectic mixture of local anaesthetic agents (EMLA) on tourniquet pain in volunteers. 269 75


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