A novel human surrogate model of noninjurious sharp mechanical pain
A novel human surrogate model of noninjurious sharp mechanical pain
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一种新型的非伤害性尖锐机械疼痛的人类替代模型
DOI：
10.1097/j.pain.0000000000000352
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发表时间：
2016
期刊：
影响因子：
7.4
通讯作者：
Baumgartner
中科院分区：
文献类型：
--
作者：
Shabes;Schloss;Magerl;Schmahl;Treede;Baumgartner
我们提出将刀片作为一种非损伤性伤害性刺激，模拟尖锐的机械性疼痛，并产生急性疼痛和痛敏反应，比点状或钝性压迫性机械性疼痛模型更接近于切口型疼痛/痛敏。对26名健康男性和女性进行调查，比较左前臂小切口与不同形状和方式的非侵入性刺激对右前臂的影响。用数值评分表评估切口痛和刀片痛的程度和时间进程。使用疼痛感觉问卷区分疼痛体验的情感成分和感觉成分。对使用7秒刀片后轴突反射血管扩张剂反应和继发性痛觉过敏的程度和时间进程进行评估。刀刃或切口处的最大疼痛相似(视觉模拟评分[平均6 SD]：32.9 6 22.5[刀片]对33.6 6 29.8[切口])，前10秒两个时间段非常接近(配对t检验；P5 0.5~1.0)，而切开而不是刀片之后出现第二阶段的疼痛，可能与组织损伤有关(减少到一半最大疼痛8 62对33 6 35秒；P，0.01)。所有刺激物的情感疼痛评分均显著低于感觉评分(P<0.001)。比较刀片和刀口，情感和感官疼痛描述的模式表现出非常相似的模式。因此，我们建议刀片作为尖锐机械疼痛的新模型，这将有助于研究术后/机械疼痛和自我伤害行为在边缘人格障碍患者中的作用。
We propose a blade as a noninjurious nociceptive stimulus modeling sharp mechanical pain and yielding acute pain and hyperalgesia responses with closer proximity to incision-induced pain/hyperalgesia than punctate or blunt pressure mechanical pain models. Twenty-six healthy men and women were investigated to compare a small incision in the left forearm with noninvasive stimuli of different shapes and modalities to the right forearm. The magnitude and time course of incisional and blade-induced pain were assessed by numerical rating scales. Affective vs sensory components of pain experience were differentiated using a pain sensation questionnaire. The magnitude and time course of the axon reflex vasodilator response and of secondary hyperalgesia following a 7-second blade application were assessed. The maximum blade or incisional pain was similar (visual analogue scale [mean 6 SD]: 32.9 6 22.5 [blade] vs 33.6 6 29.8 [incision]), and both time courses matched closely in the first 10 seconds (paired t test; P 5 0.5-1.0), whereas incision but not blade was followed by a second phase of pain, probably related to the tissue injury (decrease to half maximum pain 8 6 2 vs 33 6 35 seconds; P, 0.01). Affective pain scores were significantly lower than sensory scores for all stimuli (P, 0.001). Comparing blade and incision, patterns of affective and sensory pain descriptors exhibited a remarkably similar pattern. Hence, we suggest the blade as novel model of sharp mechanical pain, which will be useful in investigating postoperative/mechanical pain and the role of self-injurious behavior in, eg, patients with borderline personality disorder.
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