Comparative Evaluation of the Effectiveness of Different Pain-alleviating Methods before Local Anesthetic Administration in Children of 6 to 12 Years of Age: A Clinical Study

Patil, Sudha; Popali, Divya D; Bondarde, Prashant Arjun; Khandare, Nikhil S; Kothari, Akshay; Chawla, Pooja S; Gawale, Sayali; Shinde, Gaurav A; Agrawal, Rachana S; Patkar, Aditi S; Mirgal, Saurabh R

doi:10.5005/jp-journals-10005-1998

Cited by 5 publications

(6 citation statements)

References 12 publications

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“…EPT will be carried out on the right volar arm using TENS (frequency Hz, pulse duration µs, 2 circular electrodes diameter 3,2 cm). TENS is a well-tolerated system to measure electric thresholds, commonly used in therapeutic settings 43. Electrical detection threshold will be measured by single stimuli of increasing electric current until participants detect the stimulus.…”

Section: Methods and Analysismentioning

confidence: 99%

“…TENS is a welltolerated system to measure electric thresholds, commonly used in therapeutic settings. 43 Electrical detection threshold will be measured by single stimuli of increasing electric current until participants detect the stimulus. After that, a stepwise increase in mA will lead to the level of perception of pain.…”

Section: Primary Secondary and Exploratory Outcomesmentioning

confidence: 99%

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Impact of a 12-week olfactory training programme in women with migraine with aura: protocol for a double-blind, randomised, placebo-controlled trial

Faria,

Dulheuer,

Joshi

et al. 2023

BMJ Open

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IntroductionMigraine is a leading cause of disability and suffering worldwide. However, conventional pharmacological migraine preventive therapies are often challenging and accompanied by adverse effects. Recently, structured odour exposure has shown to successfully increase pain thresholds in patients with chronic back pain. Despite the importance of the olfactory system in migraine, there are no studies investigating the impact of structured odour exposure in patients with migraine.Methods and analysisThis double-blind randomised placebo-controlled trial will be conducted at the Headache Clinic of the University Pain Center at TU Dresden, Germany and aims at investigating the impact of a 12-week structured exposure to odours in women with migraine. Fifty-four women between 18 and 55 years with migraine with aura will be recruited and randomised to training with odours and odourless training. The primary outcomes are mechanical and electrical pain thresholds. Secondary outcomes comprise olfactory threshold and the number of headache days. Other exploratory measurements are headache associated pain intensity, acute analgesic intake, symptoms of anxiety and depression, and quality of life. Additionally, this protocol assesses neuroanatomical and neurofunctional changes associated with the 12-week olfactory training. Data analysis will be executed on the basis of the general linear model considering repeated measurements.Ethics and disseminationEthical approvals were obtained from the Ethics Board of the TU Dresden (Protocol No. BO-EK-353082020). Participation will only be possible after written informed consent is provided. Findings will be disseminated through peer-reviewed journals and scientific conferences.Trial registration numberDRKS00027399.

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Section: Methods and Analysismentioning

confidence: 99%

Section: Primary Secondary and Exploratory Outcomesmentioning

confidence: 99%

Impact of a 12-week olfactory training programme in women with migraine with aura: protocol for a double-blind, randomised, placebo-controlled trial

Faria,

Dulheuer,

Joshi

et al. 2023

BMJ Open

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“…For the electrical detection and pain thresholds, transcutaneous electrical nerve stimulation (TENS) equipment was used. TENS is used in a therapeutic setting, so it is a well-tolerated system to measure electric thresholds in children and adolescents ( 22 ). The electrical detection threshold was measured by a single stimulus of increasing electric current until participants detected the stimulus.…”

Section: Methodsmentioning

confidence: 99%

Olfactory training reduces pain sensitivity in children and adolescents with primary headaches

Goßrau

Zaranek²,

Klimová³

et al. 2023

Front. Pain Res.

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ObjectiveHeadache prevalence among children and adolescents has increased over the last few years. Evidence-based treatment options for pediatric headaches remain limited. Research suggests a positive influence of odors on pain and mood. We investigated the effect of repeated exposure to odors on pain perception, headache-related disability, and olfactory function in children and adolescents with primary headaches.MethodsEighty patients with migraine or tension-type headache (mean 13.1 ± 3.29 years) participated, of whom 40 underwent daily olfactory training with individually selected pleasant odors for 3 months and 40 received state-of-the-art outpatient therapy as a control group. At baseline and after a 3-month follow-up, olfactory function [odor threshold; odor discrimination; odor identification; comprehensive Threshold, Discrimination, Identification (TDI) score], mechanical detection and pain threshold (quantitative sensory testing), electrical pain threshold, patient-reported outcomes on headache-related disability [Pediatric Migraine Disability Assessment (PedMIDAS)], pain disability [Pediatric Pain Disability Index (P-PDI)], and headache frequency were assessed.ResultsTraining with odors significantly increased the electrical pain threshold compared to the control group (U = 470.000; z = −3.177; p = 0.001). Additionally, olfactory training significantly increased the olfactory function (TDI score [t(39) = −2.851; p = 0.007], in particular, olfactory threshold, compared to controls (U = 530.500; z = −2.647; p = 0.008). Headache frequency, PedMIDAS, and P-PDI decreased significantly in both groups without a group difference.ConclusionsExposure to odors has a positive effect on olfactory function and pain threshold in children and adolescents with primary headaches. Increased electrical pain thresholds might reduce sensitization for pain in patients with frequent headaches. The additional favorable effect on headache disability without relevant side effects underlines the potential of olfactory training as valuable nonpharmacological therapy in pediatric headaches.

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“…Orofacial inflammatory pain is a universal healthcare complaint in pediatric patients and a major concern of national public health [1]. In general, orofacial pain results from two pathological processes: (1) tissue injury and inflammation (nociceptive pain) or (2) a primary lesion or dysfunction of the nervous system (neuropathic pain) [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…In this regard, nNOS activity appears to influence pain transmission [10] while iNOS is expressed only in pathological conditions and is induced by proinflammatory cytokines and/or endotoxins [15]. A specific population of nNOS-positive neurons mainly mediate nociception [2]. Peripheral inflammation has been shown to alter the expression of both nNOS and iNOS in the spinal cord [16,17], suggesting that the NO level in the spinal cord is closely regulated during inflammation.…”

Section: Introductionmentioning

confidence: 99%

Peripheral Purinergic Modulation in Pediatric Orofacial Inflammatory Pain Affects Brainstem Nitroxidergic System: A Translational Research

Borsani

Ballini

Buffoli

et al. 2022

BioMed Research International

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Physiology of orofacial pain pathways embraces primary afferent neurons, pathologic changes in the trigeminal ganglion, brainstem nociceptive neurons, and higher brain function regulating orofacial nociception. The goal of this study was to investigate the nitroxidergic system alteration at brainstem level (spinal trigeminal nucleus), and the role of peripheral P2 purinergic receptors in an experimental mouse model of pediatric inflammatory orofacial pain, to increase knowledge and supply information concerning orofacial pain in children and adolescents, like pediatric dentists and pathologists, as well as oro-maxillo-facial surgeons, may be asked to participate in the treatment of these patients. The experimental animals were treated subcutaneously in the perioral region with pyridoxalphosphate-6-azophenyl-2 ′ ,4 ′ -disulphonic acid (PPADS), a P2 receptor antagonist, 30 minutes before formalin injection. The pain-related behavior and the nitroxidergic system alterations in the spinal trigeminal nucleus using immunohistochemistry and western blotting analysis have been evaluated. The local administration of PPADS decreased the face-rubbing activity and the expression of both neuronal and inducible nitric oxide (NO) synthase isoforms in the spinal trigeminal nucleus. These results underline a relationship between orofacial inflammatory pain and nitroxidergic system in the spinal trigeminal nucleus and suggest a role of peripheral P2 receptors in trigeminal pain transmission influencing NO production at central level. In this way, orofacial pain physiology should be elucidated and applied to clinical practice in the future.

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Comparative Evaluation of the Effectiveness of Different Pain-alleviating Methods before Local Anesthetic Administration in Children of 6 to 12 Years of Age: A Clinical Study

Cited by 5 publications

References 12 publications

Impact of a 12-week olfactory training programme in women with migraine with aura: protocol for a double-blind, randomised, placebo-controlled trial

Impact of a 12-week olfactory training programme in women with migraine with aura: protocol for a double-blind, randomised, placebo-controlled trial

Olfactory training reduces pain sensitivity in children and adolescents with primary headaches

Peripheral Purinergic Modulation in Pediatric Orofacial Inflammatory Pain Affects Brainstem Nitroxidergic System: A Translational Research

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