Classification of circadian pain rhythms and pain characteristics in chronic pain patients

Tanaka, Yoichi; Shigetoh, Hayato; Sato, Gosuke; Fujii, Ren; Imai, Ryota; Osumi, Michihiro; Morioka, Shigefumi

doi:10.1097/md.0000000000026500

Cited by 7 publications

(10 citation statements)

References 44 publications

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“…Patients were asked to report if they felt any abnormal sensation of burning, cold, or stinging at the site of cream application and were followed up at 0, 2, and 6 hours for the same. The study was conducted between 9 AM and 11 AM to minimize the influence of circadian difference on pain sensitivity [ 20 ].…”

Section: Methodsmentioning

confidence: 99%

Efficacy of Estradiol Cream for Venipuncture Pain in Obese Female Patients: A Pilot Study

Jayanthi¹,

Yadav²,

Reena³

et al. 2022

Cureus

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Introduction: Venipuncture is often a painful procedure causing significant anxiety, distress, and psychological consequences. We evaluated the efficacy of estradiol cream and compared it with a eutectic mixture of local anesthetics (EMLA) cream for alleviation of venipuncture pain and to make cannulation easy in female obese patients. Materials and methods: The clearance from the Institutional Ethical Committee as well as prior written and informed consent were obtained from the participants. A total of 105 obese female adult patients aged between 25 and 64 years belonging to the American Society of Anesthesiologists (ASA) physical status I and II with body mass index (BMI) > 30 kg/m 2 were included in our study. The study participants were randomly allocated into three groups: In group I, a placebo cream was applied; in group II, estradiol cream was applied, and in group III, EMLA cream was applied. Any abnormal sensation at the site of application of the cream was noted and followed up at 0, 2, and 6 hours for the same. The primary outcome was the measurement of the severity of the pain experienced during venipuncture using the visual analog scale (VAS). Ease of cannulation was our secondary outcome. VAS was compared with the Z test. Statistical Package for the Social Sciences (SPSS) v16.0 software (SPSS Inc., Chicago) was used for statistical analysis. A p-value of <0.05 was considered statistically significant. Result: The final analysis was carried out on 25 patients in group I, 27 patients in group II, and 33 patients in group III. There was no significant improvement in the ease of cannulation in group II when compared to group I. The mean VAS was similar in group I and group II, whereas it was significantly reduced in group III (p < 0.05). Conclusion: EMLA cream was found to significantly reduce the pain of venipuncture in comparison to placebo and estradiol cream. There is no beneficial effect of estradiol cream in reducing the pain from venipuncture or in ease of cannulation compared to placebo.

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Section: Methodsmentioning

confidence: 99%

Efficacy of Estradiol Cream for Venipuncture Pain in Obese Female Patients: A Pilot Study

Jayanthi¹,

Yadav²,

Reena³

et al. 2022

Cureus

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“…Variations in peak pain intensity have also been observed in headache conditions ( Burish et al, 2019 ). Other work examining a population of patients with heterogeneous chronic pain reported three differing active phase pain rhythms in separate clusters of patients ( Tanaka et al, 2021 ). Finally, another study observed pain rhythms in patients with diabetic peripheral neuropathy or postherpetic neuralgia.…”

Section: Circadian Rhythms Of Pain Behavior and Pain Sensitivitymentioning

confidence: 99%

The disruptive relationship among circadian rhythms, pain, and opioids

2023

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Pain behavior and the systems that mediate opioid analgesia and opioid reward processing display circadian rhythms. Moreover, the pain system and opioid processing systems, including the mesolimbic reward circuitry, reciprocally interact with the circadian system. Recent work has demonstrated the disruptive relationship among these three systems. Disruption of circadian rhythms can exacerbate pain behavior and modulate opioid processing, and pain and opioids can influence circadian rhythms. This review highlights evidence demonstrating the relationship among the circadian, pain, and opioid systems. Evidence of how disruption of one of these systems can lead to reciprocal disruptions of the other is then reviewed. Finally, we discuss the interconnected nature of these systems to emphasize the importance of their interactions in therapeutic contexts.

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“…All sessions were conducted in the same clinical setting, in a quiet room with ambient light, temperature, and humidity-controlled between 23ºC-24ºC and 30%-35%, respectively. Participants were assessed at approximately the same time of the day to increase repeatable testing conditions between days [22]. Prior to running the psychophysical tests, participants completed a battery of questionnaires on sleep disturbances with the Medical www.epain.org…”

Section: Participants and Proceduresmentioning

confidence: 99%

Long-term consistency of clinical sensory testing measures for pain assessment

et al. 2023

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Background: Understanding the stability of quantitative sensory tests (QSTs) over time is important to aid clinicians in selecting a battery of tests for assessing and monitoring patients. This study evaluated the short-and long-term reliability of selected QSTs. Methods: Twenty healthy women participated in three experimental sessions: Baseline, 2 weeks, and 6 months. Measurements included pressure pain thresholds (PPT) in the neck, upper back, and leg; Pressure-cuff pain tolerance around the upper-arm; conditioned pain modulation during a pressure-cuff stimulus; and referred pain following a suprathreshold pressure stimulation. Intraclass correlation coefficients (ICC) and minimum detectable change (MDC) were calculated. Results: Reliability for PPT was excellent for all sites at 2 weeks (ICC, 0.96-0.99; MDC, 22-55 kPa) and from good to excellent at 6 months (ICC, 0.88-0.95; MDC, 47-91 kPa). ICC for pressure-cuff pain tolerance indicated excellent reliability at both times (0.91-0.97). For conditioned pain modulation, reliability was moderate for all sites at 2 weeks (ICC, 0.57-0.74; MDC, 24%-35%), while it was moderate at the neck (ICC, 0.54; MDC, 27%) and poor at the upper back and leg at 6 months. ICC for referred pain areas was excellent at 2 weeks (0.90) and good at 6 months (0.86). Conclusions: PPT, pressure pain tolerance, and pressure-induced referred pain should be considered reliable procedures to assess the pain-sensory profile over time. In contrast, conditioned pain modulation was shown to be unstable. Future studies prospectively analyzing the pain-sensory profile will be able to better calculate appropriate sample sizes.

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Classification of circadian pain rhythms and pain characteristics in chronic pain patients

Cited by 7 publications

References 44 publications

Efficacy of Estradiol Cream for Venipuncture Pain in Obese Female Patients: A Pilot Study

Efficacy of Estradiol Cream for Venipuncture Pain in Obese Female Patients: A Pilot Study

The disruptive relationship among circadian rhythms, pain, and opioids

Long-term consistency of clinical sensory testing measures for pain assessment

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