Ethnic differences in pain tolerance: Clinical implications in a chronic pain population
Ethnic differences in pain tolerance: Clinical implications in a chronic pain population
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DOI：
10.1097/00006842-200103000-00018
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发表时间：
2001-03-01
影响因子：
3.3
通讯作者：
Lowery, D
中科院分区：
文献类型：
--
作者：
Edwards, RR;Doleys, DM;Lowery, D
目的：虽然许多研究已经独立地研究了临床和实验疼痛的种族差异，很少有研究在同一样本中对受控伤害性刺激和临床疼痛报告的敏感性差异。本实验研究了种族（非裔美国人与白色）对实验性疼痛耐受性和慢性疼痛调整的影响。研究方法：337名（68名非洲裔美国人和269名白色）慢性疼痛患者被转诊到多学科治疗中心参与了这项研究。除了完成一些评估慢性疼痛调整的标准化问卷外，参与者还接受了次最大努力止血带手术。这种实验性疼痛程序产生了对受控伤害性刺激（例如手臂缺血）的耐受性的测量。结果：非裔美国人的受试者报告的临床疼痛水平较高，以及更大的疼痛相关的残疾比白色参与者。此外，观察到缺血性疼痛耐受性的显著组间差异，非裔美国人的耐受性低于白人。相关性分析显示，缺血性疼痛耐受性和慢性疼痛严重程度之间存在一个小但显著的负相关关系。结论：总的来说，这些发现支持以前的研究揭示种族差异的反应，临床和实验疼痛。此外，目前的研究结果表明，增强对伤害性刺激的敏感性的一部分，非洲裔美国人可能与种族差异报告的临床疼痛，虽然种族差异的幅度是更大的缺血性疼痛的耐受性比临床疼痛的措施。
Objective: Although numerous studies have independently examined ethnic differences in clinical and experimental pain, few have investigated differences in both sensitivity to controlled noxious stimuli and clinical pain reports in the same sample. The present experiment examined the effects of ethnicity (African American vs. white) on experimental pain tolerance and adjustment to chronic pain. Methods: Three hundred thirty-seven (68 African American and 269 white) patients with chronic pain referred to a multidisciplinary treatment center participated in the study. In addition to completing a number of standardized questionnaires assessing adjustment to chronic pain, participants underwent a submaximal effort tourniquet procedure. This experimental pain procedure yields a measure of tolerance for a controlled noxious stimulus tie, arm ischemia). Results: African American subjects reported higher levels of clinical pain as well as greater pain-related disability than white participants. In addition, substantial group differences were observed for ischemic pain tolerance, with African Americans demonstrating less tolerance than whites. Correlational analyses revealed a small but significant inverse relationship between ischemic pain tolerance and the reported severity of chronic pain. Conclusions: Collectively these findings support previous research revealing ethnic differences in responses to both clinical and experimental pain. Moreover, the present results suggest that enhanced sensitivity to noxious stimuli on the part of African Americans may be associated with ethnic differences in reported clinical pain, although the magnitude of ethnic differences was much greater for ischemic pain tolerance than for clinical pain measures.