Age and preoperative pain are major confounders for sex differences in postoperative pain outcome: A prospective database analysis

Zheng, Hua; Schnabel, Alexander; Yahiaoui-Doktor, Maryam; Meißner, Winfried; Aken, Hugo Van; Zahn, Peter; Pogatzki-Zahn, Esther

doi:10.1371/journal.pone.0178659

Cited by 50 publications

(50 citation statements)

References 29 publications

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“…Sex difference in responses to acute and chronic pain have been reported in both animal and human studies. Previous human studies have shown that women have higher sensitivity, lower pain threshold and poorer tolerance for clinical pain than that in the men [1][2][3]. Recent animal studies have found that female animals showed greater behavioral nociceptive responses to peripheral injury [4,5].…”

Section: Introductionmentioning

confidence: 99%

Sex difference in synaptic plasticity in the anterior cingulate cortex of adult mice

Liu

Xue

et al. 2020

Mol Brain

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Sex differences in certain types of pain sensitivity and emotional responses have been previously reported. Synaptic plasticity is a key cellular mechanism for pain perception and emotional regulation, including long-term potentiation (LTP) and long-term depression (LTD). However, it is unclear whether there is a sex difference at synaptic level. Recent studies indicate that excitatory transmission and plasticity in the anterior cingulate cortex (ACC) are critical in chronic pain and pain related emotional responses. In the present study, we used 64-channel multielectrode (MED64) system to record synaptic plasticity in the ACC of male and female adult mice. We found that there was no significant difference in theta-burst stimulation (TBS)-induced LTP between female and male mice. Furthermore, the recruitment of inactive channels was also not different. For LTD, we found that LTD was greater in slices of ACC in male mice than female mice. Our results demonstrate that LTP in the ACC does not show any sex-related difference.

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Section: Introductionmentioning

confidence: 99%

Sex difference in synaptic plasticity in the anterior cingulate cortex of adult mice

Liu

Xue

et al. 2020

Mol Brain

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“…Moreover, the elderly population is increasing over time and is more likely to complain of painful conditions than other age groups [ 9 ]. Age was a major confounder of the sex differences in postoperative pain outcomes, especially in patients older than 50 years [ 10 ], and failure to manage pain in elderly populations might lead to serious adverse events [ 11 ]. Orthopedic patients are particularly less satisfied than other patients in terms of pain management [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Orthopedic Professionals’ Recognition and Knowledge of Pain and Perceived Barriers to Optimal Pain Management at Five Hospitals

et al. 2018

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Pain is a challenge for orthopedic healthcare professionals (OHCP). However, pain studies examined the competencies of a single OHCP category, did not consider various pain management domains or barriers to optimal pain service, and are deficient across the Arabic Eastern Mediterranean region. We surveyed OHCP’s recognition and knowledge of pain and perceived barriers to optimal pain service (361 OHCP, five hospitals). Chi square compared doctors’ (n = 63) vs. nurses/physiotherapists’ (n = 187) views. In terms of pain recognition, more nurses had pain management training, confidently assessed pediatric/elderly pain, were aware of their departments’ pain protocols, and felt that their patients receive proper pain management. More doctors comfortably prescribed opiate medications and agreed that some nationalities were more sensitive to pain. For pain knowledge, more nurses felt patients are accurate in assessing their pain, vital signs are accurate in assessing children’s pain, children feel less pain because of nervous system immaturity, narcotics are not preferred due respiratory depression, and knew pre-emptive analgesia. As for barriers to optimal pain service, less nurses agreed about the lack of local policies/guidelines, knowledge, and skills; time to pre-medicate patients; knowledge about medications; complexity of the clinical environment; and physicians being not comfortable prescribing pain medication. We conclude that doctors required confidence in pain, especially pediatric and geriatric pain, using vital signs in assessing pain and narcotics use. Their most perceived barriers were lack of local policies/guidelines and skills. Nurses required more confidence in medications, caring for patients on narcotics, expressed fewer barriers than doctors, and the complexity of the clinical environment was their highest barrier. Educational programs with clinical application could improve OHCPs’ pain competencies/clinical practices in pain assessment and administration of analgesics.

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“…33 [27][28][29][30][31][32][33][34][35][36][37][38] Dysmenorrhea Numerical Rating Scale Score (0-10) 8 (0-10) [7][8][9] Dyspareunia Numerical Rating Scale Score (0-10) 7 (0-10) [5][6][7][8] Non-cyclical Pain Numerical Rating Scale Score (0-10) 8 (0-10) [6][7][8][9] Duration of Pain Symptoms (years) 18 (1-47) [13][14][15][16][17][18][19][20][21][22][23][24] Number of surgeries to the abdomen…”

Section: Median (Range) [Iqr]mentioning

confidence: 99%

Is there a neuropathic-like component to endometriosis-associated pain? Results from a large cohort questionnaire study

Coxon

Wiech

Vincent

2020

Preprint

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AbstractBackgroundPain is one of the primary symptoms of endometriosis, a chronic inflammatory condition characterised by the presence of endometrial tissue outside the uterus. Endometriosis-associated pain is commonly considered as nociceptive in nature but its clinical presentation suggests that it might have neuropathic-like properties in a subgroup of patients.MethodsThis is a cross sectional study using an online survey. The survey was distributed by patient support websites. The survey was composed of validated questionnaires assessing pain symptoms, psychological measures and questions about number of surgeries.Main results and the role of chanceWe had 1417 responses which met the inclusion criteria. Using standard painDETECT cut-off scores, we found that pain was classified as neuropathic in 40% of patients and as mixed neuropathic/nociceptive in a further 35%. In line with observations in other neuropathic conditions, the neuropathic subgroup reported higher pain intensities, greater psychological distress and cognitive impairment. Neuropathic pain was also more likely in those with more surgeries to the abdomen and a longer history of pain. As revealed by a cluster analysis, those with a neuropathic pain component could further be divided into two subgroups based on their sensory profile.ConclusionsThe data presented here indicate that endometriosis-associated pain includes a neuropathic-like component in a substantial proportion of women. Although further investigation is required, our finding challenges the current conceptualisation of endometriosis-associated pain as nociceptive and advocates for a new perspective on this type of pain, which is so debilitating to a large number of women.

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Age and preoperative pain are major confounders for sex differences in postoperative pain outcome: A prospective database analysis

Cited by 50 publications

References 29 publications

Sex difference in synaptic plasticity in the anterior cingulate cortex of adult mice

Sex difference in synaptic plasticity in the anterior cingulate cortex of adult mice

Orthopedic Professionals’ Recognition and Knowledge of Pain and Perceived Barriers to Optimal Pain Management at Five Hospitals

Is there a neuropathic-like component to endometriosis-associated pain? Results from a large cohort questionnaire study

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