Scientiﬁc presentations at the 2017 Annual Meeting / Scandinavian Journal of Pain 16 (2017) 165–188at activity and the individual expectations should be furtherfocused.http://dx.doi.org/10.1016/j.sjpain.2017.04.046Paradoxical differences in pain ratings of thesame stimulus intensityM.E. McPhee a,∗ , K.K. Petersen a , M.S. Hoegh b , T.Graven-Nielsen baSMI, Department of Health Science and Technology,Aalborg University, Denmarkb Center for Neuroplasticity and Pain (CNAP), SMI,Department of Health Science and Technology,Aalborg University, DenmarkE-mail address: firstname.lastname@example.org (M.E. McPhee).Aims: Stimulus intensity used for assessing temporal summation of pain (TSP) is commonly set at the participants’ paintolerance. Yet pain ratings during TSP rarely reach that initial paintolerance pain rating. This study aimed to explore the differencesbetween baseline pain tolerance assessed by cuff algometry andsubsequent pain ratings of the same stimulus intensity, and thereliability of these ratings over 2 sessions.Methods: In two sessions, separated by one week, 24 healthy,pain-free males had their pressure pain detection (PDT) and tolerance threshold (PTT) recorded using a staircase inﬂation paradigm(5 kPa increments, 1sec-ON:4sec-OFF) with a cuff algometry system. The pain intensity was assessed during cuff stimulation usingan electronic visual analogue scale (VAS, 0–10 cm). Three different inﬂation paradigms were then performed, using the PTT levelas stimulation intensity, and a 1-s duration for each stimulus:PEAKS: 3 inﬂations at 0.17 Hz, SLOW: 10 inﬂations at 0.01 Hz, FAST:10 inﬂations at 0.5 Hz). Approximately 5-min was kept betweenthe staircase assessment and the ﬁrst stimulation paradigm, andbetween each of the 3 inﬂation paradigms. The PTT and ﬁrst inﬂation VAS rating from each paradigm was extracted.Results: The VAS rating of PTT pressure was higher in thestaircase (VAS: 8.5 ± 2.1 cm) than the ﬁrst PPT stimulus in anyother paradigm (PEAKS: 5.4 ± 2.0; SLOW: 4.6 ± 2.1; FAST: 4.0 ± 2.3,P < 0.05). VAS ratings were also lower in each subsequent paradigm(i.e. PEAKS > SLOW > FAST, P < 0.05). Intra-class coefﬁcients demonstrated excellent reliability for each paradigm (all ICC > 0.79)between sessions.Conclusions: PTT, as assessed with the staircase inﬂationparadigm, was rated more painful during baseline assessment thanwhen the identical stimulus proﬁle (PPT intensity for 1-s) wasapplied afterwards and this ﬁnding is considered reliable.http://dx.doi.org/10.1016/j.sjpain.2017.04.047Pain assessment and post-operative painmanagement in orthopedic patientsW. Schmelling a,∗ , J.N. Poulsen b , L. Christrup c , P.Gazerani baBispebjerg Hospital, Region Hovedstaden,Copenhagen, Denmarkb Department of Health science and Technology,Aalborg University, Aalborg, Denmarkc Department of Pharmacology andPharmaco-therapy, Faculty of PharmaceuticalSciences, University of Copenhagen, Copenhagen,DenmarkE-mail address: Winnie.Schmelling@regionh.dk (W. Schmelling).181Aims: A fast-track based surgical treatment reduces morbidity and hospital stay by providing early mobilization. Sufﬁcientpostoperative pain management is mandatory for early mobilization and optimal utilization of rehabilitation measures. Insufﬁcientpostoperative pain management is however a widespread problem.Lack of knowledge about pain and pain treatment among healthcare professionals and general community has been considered asa major potential contributor in insufﬁcient pain management. Ithas been suggested that severe postoperative pain might imply apotential risk of developing chronic pain. The purpose of this studywas to examine this problem in acute and elective surgical patientsin department of orthopedic surgery at Bispebjerg Hospital in orderto identify obstacles and possibilities for future improvement.Methods: Questionnaires were developed and distributed topatients consisted of 10 acute admitted and 10 elective orthopedic patients. The patients’ pain scores were recorded with a 0–10NRS scale. The scores were obtained for current pain in rest, currentpain in activity, and the highest and lowest pain intensity for thelast 24 hours. Data were handled using descriptive statistics.Results: The goal for sufﬁcient pain treatment was patients withpain score at ≤3 NRS at rest and ≤5 in activity. For pain at rest 45%of the patients were within the goal range and 55% for the currentpain in activity. For the mildest pain experienced in the last 24 h,75% and for the worst pain experienced 30% of the patients reachedthe goal.Conclusions: Corresponding to similar studies, half of thepatients received a sufﬁcient pain treatment at the time of examination. The consequences for insufﬁcient pain management would bereduced effect of the physiotherapy, reduced ability to handle everyday activity, sleep disturbances, and potential risk of developingchronic pain.http://dx.doi.org/10.1016/j.sjpain.2017.04.048Combined electric and pressure cuff painstimuli for assessing conditioning painmodulation (CPM)M. Tsukamoto a,b , K.K. Petersen a,∗ , C.D. Mørch a , L.Arendt-Nielsen aaAalborg University, Center for Sensory-MotorInteraction, Aalborg, Denmarkb Asahi Kasei Pharma Corporation, ClinicalDevelopment Center, Tokyo, JapanE-mail address: email@example.com (K.K. Petersen).Aims: Traditionally, conditioning pain modulation (CPM) canbe assessed by applying a test stimulus (TS) before and after application of a conditioning stimulus (CS), which is normally appliedextra-segmental. Currently, no studies have attempted to apply theTS and CS to the same site using different stimuli modalities. Theaim of this study was to evaluate electrical TS and cuff pressure CSapplied to the same experimental site for studying CPM.Methods: 20 male volunteers participated in this study, whichconsisted of stimulations applied by a cuff-algometer (NociTechand Aalborg University, Denmark) and current stimulator (Dig®itimer DS5, UK), through two Ag/AgCl electrodes (Ambu Neuroline700, Denmark). The cuff was wrapped around the lower leg andstimulation electrodes were placed under the cuff and to the samelocation on the contralateral leg. Electrical TS were applied to thenon-dominant leg with or without cuff pressure CS on the dominant (CS1) or the same (non-dominant) leg (CS2, electrode undercuff). The subjects were instructed to rate the electrical evoked painintensity on a 10-cm continuous visual analog scale (VAS, “0” represented “no pain”, and “10” represented “maximal pain”). The paindetection threshold (PDT) was deﬁned as “1” on the VAS scale.
Scandinavian Journal of Pain – de Gruyter
Published: Jul 1, 2017
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