ALTERED PAIN REGULATORY SYSTEMS IN CHRONIC CLINICAL PAIN

心血管相关的抗伤害性感觉(由内源性阿片类药物介导) 这是健康个体适应急性疼痛的重要组成部分。 先前的研究表明内源性阿片类药物水平可能存在缺陷 在慢性疼痛患者中，尽管对功能性的 这些赤字的影响。这项研究将：1)考察两者之间的关系 静息血压(BP)、急性疼痛敏感度和临床 慢性疼痛患者的疼痛，以及2)检查疼痛程度的差异 内源性阿片类药物对这种BP/疼痛关系的调节作用 病人和正常人。30名慢性疼痛患者和30名健康正常人 一旦服用安慰剂，就会接受实验室的缺血性疼痛刺激 一次使用纳洛酮进行阿片类药物阻断(随机、平衡 秩序)。在两次会议中，血压将在静息基线确定，以及 在整个协议中定期进行。疼痛患者也会对他们的 用药前后临床疼痛情况。和以前的工作一样， 预计法线将显示显著的正值 静息血压和急性疼痛敏感性之间的相关性将在 部分租约被纳洛酮取消。预计疼痛患者将 在休息和休息之间表现出很小的相关性或正相关性 BP，以及临床疼痛和急性疼痛敏感性，并将 对阿片类药物的阻断无反应。

Cardiovascular-related antinociception (mediated by endogenous opioids) is an important component of adaptation to acute pain in healthy individuals. Previous research indicates possible deficits in endogenous opioid levels in chronic pain patients, although little is known about the functional effects of these deficits. This study will: 1) examine the relationship between resting blood pressure (BP), acute pain sensitivity, and clinical pain in chronic pain patients, and 2) examine differences in degree of endogenous opioid mediation of this BP/pain relationship between pain patients and normals. Thirty chronic pain patients and 30 healthy normals will undergo a laboratory ischemic pain stimulus once under placebo and once under opioid blockade with naloxone (randomized, counter-balanced order). In both sessions, BP will be determined at resting baseline, and periodically throughout the protocol. Pain patients will also rate their clinical pain before and after drug administration. As in previous work, it is expected that normals will display a significant positive correlation between resting BP and acute pain sensitivity, which will be at lease partially eliminated by naloxone. Pain patients are expected to demonstrate little correlation or a positive correlation between resting BP, and both clinical pain and acute pain sensitivity, and will be unresponsive to opioid blockade.