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Craniofacial pain of cardiac origin is associated with inferior wall ischemia.
CONCLUSION: The occurrence of craniofacial pain during myocardial ischemia, with or without an acute myocardial infarction, was associated with ischemia within the inferior wall. This result suggests the involvement of the vagal afferent system in the mechanisms of craniofacial pain of cardiac origin. PMID: 25347166 [PubMed - in process]
Source: Journal of Orofacial Pain - November 25, 2014 Category: ENT & OMF Tags: J Oral Facial Pain Headache Source Type: research

Pain medication and long QT syndrome.
Authors: Klivinyi C, Bornemann-Cimenti H Abstract Long QT syndrome is a cardiac repolarization disorder and is associated with an increased risk of torsades de pointes. The acquired form is most often attributable to administration of specific medications and/or electrolyte imbalance. This review provides insights into the risk for QT prolongation associated with drugs frequently used in the treatment of chronic pain. In the field of pain medicine all the major drug classes (i.e. NSAIDs, opioids, anticonvulsive and antidepressant drugs, cannabinoids, muscle relaxants) contain agents that increase the risk of QT pro...
Source: Korean Journal of Pain - January 28, 2018 Category: Anesthesiology Tags: Korean J Pain Source Type: research

Sickle Cell Subjects Have a Stronger and Faster Neurally Mediated Vasoconstriction Response to Cold Pain That Correlates with Anxiety Scores
Conclusion: Using MBF as an objective marker of pain responses, cold pain causes significant decrease in MBF followed by other thermal stimuli. The rapid vasoconstriction responses to the thermal stimuli occurred in the contralateral hand, suggesting a neural mechanism. SCD subjects demonstrated an augmented peripheral vasoconstriction response with evidence of cardiac autonomic imbalance. Our findings imply that global autonomic mediated vasoconstriction and subsequent vaso-occlusion is the likely mechanistic link between cold exposure and VOC in SCD. Thus, vascular autonomic reactivity is a biomarker of basic SCD pathoph...
Source: Blood - November 21, 2018 Category: Hematology Authors: Veluswamy, S., Shah, P., Khaleel, M., Puliyel, M., Thuptimdang, W., Chalacheva, P., Sunwoo, J., Denton, C. C., Kato, R. M., Detterich, J. A., Wood, J. C., Sposto, R., Khoo, M., Zeltzer, L., Coates, T. D. Tags: 114. Hemoglobinopathies, Excluding Thalassemia-Clinical: Pain and Pain Management in Sickle Cell Disease Source Type: research

Prediction of pain using electrocardiographic ‐derived autonomic measures: A systematic review
ConclusionsMost studies demonstrated that parasympathetic activity could predict acute and chronic pain intensity. In the clinic, this may be used to identify which patients need more intensive care to prevent, for example postoperative pain and develop personalized chronic pain management.SignificancePain is a debilitating problem, and the ability to predict occurrence and severity would be a useful clinical tool. Basal autonomic tone has been suggested to influence pain perception. This systematic review investigated electrocardiographic-derived autonomic tone and found that increased parasympathetic tone could predict p...
Source: European Journal of Pain - September 1, 2023 Category: Anesthesiology Authors: Anne ‐Marie Wegeberg, Trine Hyttel Sejersgaard‐Jacobsen, Christina Brock, Asbjørn Mohr Drewes Tags: REVIEW ARTICLE Source Type: research

Chronic Pain and Heart Rate Variability in a Cross-Sectional Occupational Sample: Evidence for Impaired Vagal Control
Discussion: Our results suggest that the DIP indexed by vagal activity operationalized as RMSSD is disturbed in persons with chronic pain. Furthermore, the correlations between RMSSD and pain are different between those without and those with chronic pain. The findings are discussed, emphasizing changes in brain activity and the comorbid dysregulation of emotion in patients with chronic pain, to provide implications for the treatment of chronic pain.
Source: The Clinical Journal of Pain - February 20, 2016 Category: Anesthesiology Tags: Original Articles Source Type: research

Interacting influences of gender and chronic pain status on parasympathetically mediated heart rate variability in adolescents and young adults
Abstract: Considerable research links chronic pain to autonomic nervous system (ANS) dysfunction, specifically low heart rate variability (HRV) mediated by reduced parasympathetic activity. However, little is known about factors that influence ANS function in chronic pain. The ANS is the primary pathway for brain–gut communication, making it of particular interest in gastrointestinal disorders, such as irritable bowel syndrome, characterized by functional abdominal pain (FAP). We evaluated the relation of sex, pain severity, and psychological stress to ANS function in adolescents/young adults from a database of pediatric...
Source: Pain - July 26, 2017 Category: Anesthesiology Tags: Research Paper Source Type: research

The Association of (Effective and Ineffective) Analgesic Intake, Pain Interference and Heart Rate Variability in a Cross‐Sectional Occupational Sample
ConclusionIn line with previous research, vmHRV is inversely associated with pain interference. Analgesic intake mediates the association of vmHRV and pain. Effective analgesic self‐medication may lead to a restoration in vmHRV. These results further support the vagus nerve as an objective indication of pain severity and treatment efficacy in patients with persistent pain.
Source: Pain Medicine - May 29, 2015 Category: Anesthesiology Authors: Julian Koenig, Marc N Jarczok, Joachim E Fischer, Julian F Thayer Tags: Brief Research Report Source Type: research

Treating Chest Pain With a Cup of Tea
By ANISH KOKA, MD It is very early.  I am running to the ‘clinical decision unit’ (CDU) to see a patient of mine sent in the night before from a local skilled nursing facility.  Also known as clinical observation units,  ‘obs’ units, or short stay observation units, these units were designed to help decompress busy emergency rooms and divert unnecessary, expensive inpatient admissions.  The units are typically adjacent to emergency departments, and usually are run by emergency physicians. My particular patient was admitted due to an episode of chest pain at her facility.  A brief conversation t...
Source: The Health Care Blog - January 9, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized CCTA Chest Pain EHR Source Type: blogs

Efficacy of Implementation of a Chest Pain Center at a Community Hospital.
DISCUSSION: The data showed a significant reduction in total length of stay for all chest pain patients. This retrospective program evaluation demonstrated some evidence in using HEART score to safely risk stratify chest pain patients to the appropriate level of care. As healthcare moves from a fee-for-service environment to value-based purchasing, hospitals need to devise and implement innovative strategies to provide efficient, beneficial, and safe care for the patients. PMID: 29135621 [PubMed - in process]
Source: Pain Physician - November 16, 2017 Category: Anesthesiology Authors: Davis A, Chiu J, Lau SK, Kok YJ, Wu JYH Tags: Crit Pathw Cardiol Source Type: research

Cognitive self-regulation influences pain-related physiology
In this study, participants (N = 41) deployed a cognitive strategy based on reappraisal and imagination to regulate pain up or down on different trials while skin conductance responses (SCRs) and electrocardiogram activity were recorded. Using a machine learning approach, we first developed stimulus-locked SCR and electrocardiogram physiological markers predictive of pain ratings. The physiological markers demonstrated high sensitivity and moderate specificity in predicting pain across 2 data sets, including an independent test data set (N = 84). When we tested the markers on the cognitive self-regulation data, we found th...
Source: Pain - September 26, 2019 Category: Anesthesiology Tags: Research Paper Source Type: research

Efficacy and Safety of Intravenous Meloxicam in Patients With Moderate-to-Severe Pain Following Bunionectomy: A Randomized, Double-Blind, Placebo-controlled Trial
Discussion: Meloxicam IV doses of 30 mg provided effective pain relief when administered once daily by bolus injection to patients with moderate-to-severe pain following bunionectomy, and had an acceptable safety profile.
Source: The Clinical Journal of Pain - September 5, 2018 Category: Anesthesiology Tags: Original Articles Source Type: research

Methadone Safety: A Clinical Practice Guideline From the American Pain Society and College on Problems of Drug Dependence, in Collaboration With the Heart Rhythm Society
Abstract: Methadone is used for the treatment of opioid addiction and for treatment of chronic pain. The safety of methadone has been called into question by data indicating a large increase in the number of methadone-associated overdose deaths in recent years that has occurred in parallel with a dramatic rise in the use of methadone for chronic pain. The American Pain Society and the College on Problems of Drug Dependence, in collaboration with the Heart Rhythm Society, commissioned an interdisciplinary expert panel to develop a clinical practice guideline on safer prescribing of methadone for treatment of opioid addictio...
Source: The Journal of Pain - March 31, 2014 Category: Materials Science Authors: Roger Chou, Ricardo A. Cruciani, David A. Fiellin, Peggy Compton, John T. Farrar, Mark C. Haigney, Charles Inturrisi, John R. Knight, Shirley Otis-Green, Steven M. Marcus, Davendra Mehta, Marjorie C. Meyer, Russell Portenoy, Seddon Savage, Eric Strain, Sh Tags: Methadone Safety Guidelines Source Type: research

Combined non‐pharmacological interventions for newborn pain relief in two degrees of pain procedures: A randomized clinical trial
ConclusionNon‐nutritive sucking and swaddling had synergistic effects on pain relief when used with oral sucrose. For the deep heel stick procedure, oral sucrose combined with NNS and swaddling provided the best pain relief effect. For the shallow heel stick procedure, addition of NNS and swaddling did not improve the effects.
Source: European Journal of Pain - December 18, 2015 Category: Anesthesiology Authors: H.‐Y. Leng, X.‐L. Zheng, X.‐H. Zhang, H.‐Y. He, G.‐F. Tu, Q. Fu, S.‐N. Shi, L. Yan Tags: Original Article Source Type: research

(438) A 24-week extension of an open-label, long-term safety study evaluating the safety and effectiveness of once-daily, single-entity, hydrocodone in patients with chronic nonmalignant and non-neuropathic pain
HYD is a once-daily, single-entity hydrocodone bitartrate tablet formulated with abuse-deterrent properties that is under development for treatment of moderate-to-severe chronic pain. This 24-week extension of a long-term, open-label study with a 12-month maintenance period characterized the safety, effectiveness, and impact on quality of life (QoL) measures of HYD (20, 40, 60, 80, 120 mg/day) treatment in patients with moderate-to-severe chronic non-malignant and non-neuropathic pain. Evaluations included adverse events (AEs), aberrant drug behaviors, audiologic and clinical laboratory assessments, ECGs, average daily pai...
Source: The Journal of Pain - March 27, 2015 Category: Materials Science Authors: W. Wen, L. Taber, S. Lynch, E. He, S. Ripa Source Type: research

Pulse Transit Time as a Predictor of the Efficacy of a Celiac Plexus Block in Patients With Chronic Intractable Abdominal Pain
This study evaluated whether measurement of the electrocardiographic R-wave and the arrival time of the pulses at the toe pulse transit time (E-T PTT) can be an early predictor of pain response and success of CPB in patients with chronic intractable visceral pain. Methods: Twelve patients aged between 20 and 80 years who underwent CPB for treatment of chronic intractable cancer-related abdominal pain were included. A successful CPB was determined as a>50% decrease on the numerical rating scale measured 24 hours after the procedure. The E-T PTT at baseline and at 5, 10, 20, and 30 minutes after the injection of local anest...
Source: The Clinical Journal of Pain - May 18, 2016 Category: Anesthesiology Tags: Original Articles Source Type: research