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Single and double pain responses to individually titrated ultra-short laser stimulation in humans

Engskov, Anna Sellgren LU ; Rubin, Agneta Troilius LU and Åkeson, Jonas LU (2019) In BMC Anesthesiology 19(1).
Abstract


Background: This preclinical study in humans was designed to selectively induce delayed nociceptive pain responses to individually titrated laser stimulation, enabling separate bedside intensity scoring of both immediate and delayed pain. Methods: Forty-four (fourteen female) healthy volunteers were subjected to repeated nociceptive dermal stimulation in the plantar arc, based on ultra-short carbon dioxide laser with individually titrated energy levels associated with mild pain. Results: Data was analysed in 42 (12 female) subjects, and 29 of them (11 females) consistently reported immediate and delayed pain responses at second-long intervals to each nociceptive stimulus. All... (More)


Background: This preclinical study in humans was designed to selectively induce delayed nociceptive pain responses to individually titrated laser stimulation, enabling separate bedside intensity scoring of both immediate and delayed pain. Methods: Forty-four (fourteen female) healthy volunteers were subjected to repeated nociceptive dermal stimulation in the plantar arc, based on ultra-short carbon dioxide laser with individually titrated energy levels associated with mild pain. Results: Data was analysed in 42 (12 female) subjects, and 29 of them (11 females) consistently reported immediate and delayed pain responses at second-long intervals to each nociceptive stimulus. All single pain responses were delayed and associated with lower levels (p = 0.003) of laser energy density (median 61; IQR 54-71 mJ/mm
2
), compared with double pain responses (88; 64-110 mJ/mm
2
). Pain intensity levels associated with either kind of response were readily assessable at bedside. Conclusions: This study is the first one to show in humans that individually titrated ultra-short pulses of laser stimulation, enabling separate pain intensity scoring of immediate and delayed responses at bedside, can be used to selectively induce and evaluate delayed nociceptive pain, most likely reflecting C-fibre-mediated transmission. These findings might facilitate future research on perception and management of C-fibre-mediated pain in humans.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Humans, Lasers, Nerve fibers, Nociceptive pain, Nociceptors, Pain measurement, Visual analog scale
in
BMC Anesthesiology
volume
19
issue
1
article number
29
publisher
BioMed Central (BMC)
external identifiers
  • pmid:30832563
  • scopus:85062397411
ISSN
1471-2253
DOI
10.1186/s12871-019-0702-1
language
English
LU publication?
yes
id
e38b768e-880f-4e4d-a735-a4bb5a2c25db
date added to LUP
2019-03-12 12:53:55
date last changed
2021-01-06 01:14:41
@article{e38b768e-880f-4e4d-a735-a4bb5a2c25db,
  abstract     = {<p><br>
                                                         Background: This preclinical study in humans was designed to selectively induce delayed nociceptive pain responses to individually titrated laser stimulation, enabling separate bedside intensity scoring of both immediate and delayed pain. Methods: Forty-four (fourteen female) healthy volunteers were subjected to repeated nociceptive dermal stimulation in the plantar arc, based on ultra-short carbon dioxide laser with individually titrated energy levels associated with mild pain. Results: Data was analysed in 42 (12 female) subjects, and 29 of them (11 females) consistently reported immediate and delayed pain responses at second-long intervals to each nociceptive stimulus. All single pain responses were delayed and associated with lower levels (p = 0.003) of laser energy density (median 61; IQR 54-71 mJ/mm                             <br>
                            <sup>2</sup><br>
                                                         ), compared with double pain responses (88; 64-110 mJ/mm                             <br>
                            <sup>2</sup><br>
                                                         ). Pain intensity levels associated with either kind of response were readily assessable at bedside. Conclusions: This study is the first one to show in humans that individually titrated ultra-short pulses of laser stimulation, enabling separate pain intensity scoring of immediate and delayed responses at bedside, can be used to selectively induce and evaluate delayed nociceptive pain, most likely reflecting C-fibre-mediated transmission. These findings might facilitate future research on perception and management of C-fibre-mediated pain in humans.                         <br>
                        </p>},
  author       = {Engskov, Anna Sellgren and Rubin, Agneta Troilius and Åkeson, Jonas},
  issn         = {1471-2253},
  language     = {eng},
  month        = {03},
  number       = {1},
  publisher    = {BioMed Central (BMC)},
  series       = {BMC Anesthesiology},
  title        = {Single and double pain responses to individually titrated ultra-short laser stimulation in humans},
  url          = {http://dx.doi.org/10.1186/s12871-019-0702-1},
  doi          = {10.1186/s12871-019-0702-1},
  volume       = {19},
  year         = {2019},
}