Endorphin levels in cerebrospinal fluid of patients with postoperative and chronic pain

Puig, María Margarida Bassols i; Laorden, María‐Luisa; Miralles, F; Olaso, M. J.

doi:10.1016/0304-3959(83)90223-3

Cited by 3 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This would be consistent with results from previous cross-sectional studies in patients with chronic pain of extended duration that suggested levels of endogenous opioids are reduced relative to pain-free individuals [e.g., 1,5,11,12,19,24; see 6 for a review]. Consistent with these findings, previous work examining opioid blockade effects on acute pain responses in patients with long-duration chronic back pain also suggest impaired endogenous opioid analgesic function [5].…”

Section: Discussionsupporting

confidence: 91%

“…It has further been suggested that long-term chronic pain may develop when persistent demands to modulate ongoing nociceptive activity result in failure of descending pain inhibitory mechanisms [6,15,18]. An association between long-term chronic pain and endogenous opioid antinociceptive dysfunction is supported by cross-sectional studies indicating lower endogenous opioid levels and diminished endogenous opioid analgesic activity in chronic pain patients compared to healthy individuals [e.g., 1,5,11,12,19,24]. …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Chronic pain-related changes in endogenous opioid analgesia: A case report

Bruehl

Chung

Chont

2010

Pain

View full text Add to dashboard Cite

This case report presents data regarding endogenous opioid analgesia in a healthy female subject prior to developing chronic pain, and again 4 and 13 months following onset of chronic daily back pain. At each assessment period, the subject underwent identical protocols involving two sessions one week apart with randomized double-blind crossover administration of saline placebo and naloxone, an opioid antagonist. Each session included a 5-minute anger recall interview, followed by finger pressure and ischemic acute pain tasks. Increases in acute pain ratings induced by opioid blockade were interpreted as reflecting endogenous opioid analgesia. When the subject was healthy and pain-free, naloxone produced a mean overall 16% decrease in pain ratings relative to placebo. However, 4 months after onset of chronic pain, a mean naloxone-induced increase of 22% in pain ratings over placebo was observed, consistent with presence of endogenous opioid analgesia. The mean magnitude of this opioid blockade effect for the finger pressure task exceeded the 99% confidence interval for the healthy control population based on a previous study using a similar opioid blockade protocol (Bruehl et al., 2008). At 13-month follow-up, naloxone produced a mean 45% decrease in acute pain ratings compared to placebo, arguing against presence of endogenous opioid analgesia. Although results must be interpreted cautiously, findings are consistent with the hypothesis that chronic pain may initially be associated with upregulation of endogenous opioid analgesic systems which then may become dysfunctional over time.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Chronic pain-related changes in endogenous opioid analgesia: A case report

Bruehl

Chung

Chont

2010

Pain

View full text Add to dashboard Cite

show abstract

“…More generally, results for affective pain responses to the FP task indicated that the ARI itself (regardless of trait anger levels) produced hyperalgesia selectively in LBP participants. Although these findings should be interpreted with caution until replicated, they are consistent with the idea that individuals with chronic pain might be particularly susceptible to opioid system dysfunction, as suggested by some prior work (e.g.,[19-24]). Given the ubiquity of anger in the chronic pain population (7), it may be interesting to explore whether interventions designed to reduce anger in chronic pain patients might as a consequence improve functioning of endogenous opioid analgesic systems.…”

Section: Discussionmentioning

confidence: 99%

“…Both Healthy and LBP participants were included in the study to address the possibility that anger/opioid links might differ as a function of chronic pain status, given previous findings that persistent pain may itself potentially increase (19) or decrease endogenous opioid analgesia (e.g.,[20-24]). A priori directional hypotheses regarding the influence of chronic pain status on the effects of interest were not possible given the limited data available to inform such hypotheses.…”

Section: Methodsmentioning

confidence: 99%

Interacting Effects of Trait Anger and Acute Anger Arousal on Pain

Bruehl

Burns

Chung

et al. 2011

Psychosomatic Medicine

View full text Add to dashboard Cite

Objective Elevated trait anger (TRANG; heightened propensity to experience anger) is associated with greater pain responsiveness, possibly via associations with deficient endogenous opioid analgesia. This study tested whether acute anger arousal moderates the impact of TRANG on endogenous opioid analgesia. Methods 94 chronic low back pain participants (LBP) and 85 healthy controls received opioid blockade (8mg naloxone) or placebo in randomized, counterbalanced order in separate sessions. Participants were randomly assigned to undergo either a 5-minute anger recall interview (ARI) or neutral control interview (NCI) across both drug conditions. Immediately following the assigned interview, participants engaged sequentially in finger pressure and ischemic forearm pain tasks. Opioid blockade effects were derived (blockade minus placebo condition pain ratings) to index opioid antinociceptive function. Results Placebo condition TRANG × Interview interactions (p’s<.05) indicated that TRANG was hyperalgesic only in the context of acute anger arousal (ARI condition; p’s<.05). Blockade effect analyses suggested these hyperalgesic effects were related to deficient opioid analgesia. Significant TRANG × Interview interactions (p’s<.05) for both pain tasks indicated that elevated TRANG was associated with smaller blockade effects (less endogenous opioid analgesia) only in the ARI condition (p’s<.05). Results for ischemic task VAS intensity blockade effects suggested that associations between TRANG and impaired opioid function were most evident in LBP participants when experiencing anger (Type × Interview × TRANG Interaction; p<.05). Conclusions Results indicate that hyperalgesic effects of TRANG are most prominent when acute anger is aroused, and suggest that endogenous opioid mechanisms contribute.

show abstract

The Effects of Isotonic Rehabilitation Exercise on Lumbar Extension Strength of Scoliosis Patient

Beak

Kim

2016

Indian Journal of Science and Technology

View full text Add to dashboard Cite

Endorphin levels in cerebrospinal fluid of patients with postoperative and chronic pain

Cited by 3 publications

References 0 publications

Chronic pain-related changes in endogenous opioid analgesia: A case report

Chronic pain-related changes in endogenous opioid analgesia: A case report

Interacting Effects of Trait Anger and Acute Anger Arousal on Pain

The Effects of Isotonic Rehabilitation Exercise on Lumbar Extension Strength of Scoliosis Patient

Contact Info

Product

Resources

About