Journal of Pain Research最新文献

{"title":"Unequal Local Anesthetic Dosing and Surgical Heterogeneity: Considerations for Interpreting the ESPB-TEA Non-Inferiority Trial [Letter].","authors":"Chin-E Liu, Cheng-Wei Lu","doi":"10.2147/JPR.S619693","DOIUrl":"https://doi.org/10.2147/JPR.S619693","url":null,"abstract":"","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"619693"},"PeriodicalIF":2.5,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric Properties of a Smartphone Application for Measuring Shoulder Active Range of Motion in Individuals with and without Shoulder Pain and Mobility Deficits [Response to the Letter].","authors":"Aafreen Aafreen, Abdur Raheem Khan, Ausaf Ahmad, Yousef M Alshehre, Mohammed M Alshehri, Mohammad Abu Shaphe, Monira I Aldhahi","doi":"10.2147/JPR.S617431","DOIUrl":"https://doi.org/10.2147/JPR.S617431","url":null,"abstract":"","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"617431"},"PeriodicalIF":2.5,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Deep versus Moderate Neuromuscular Blockade on Postoperative Acute and Chronic Pain in Laparoscopic Gynecological Surgery.","authors":"Ying Zhao, Jingjing Zhang, Wei Qian, Hailing Mu, Qiushuang Tang, Peng Zhang","doi":"10.2147/JPR.S592329","DOIUrl":"https://doi.org/10.2147/JPR.S592329","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effects of deep neuromuscular blockade (D-NMB) versus moderate NMB (M-NMB) on postoperative pain and chronic postsurgical pain (CPSP) in patients undergoing laparoscopic gynecological surgery.</p><p><strong>Patients and methods: </strong>Seventy-two patients scheduled for laparoscopic uterine or adnexal surgery were randomly assigned to Group D (D-NMB, post-tetanic count 1-2) or Group M (M-NMB, train-of-four count 1-2). Postoperative pain was assessed using the visual analogue scale (VAS) at multiple time points. Surgeon satisfaction score (SRS), opioid consumption, Quality of Recovery-15 (QoR-15) score, and CPSP incidence at 3 and 6 months were compared.</p><p><strong>Results: </strong>The VAS score at 0.5 hours postoperatively was significantly lower in Group D than in Group M (4.18±1.40 vs. 5.42±1.61, P=0.001). Postoperative opioid consumption and the proportion requiring additional analgesia were significantly reduced in Group D (P=0.011 and P=0.019, respectively).SRS and QoR-15 scores were significantly higher in Group D (P<0.001 and P=0.022, respectively). No significant differences were observed in CPSP incidence or adverse reactions between the two groups.</p><p><strong>Conclusion: </strong>D-NMB improves early postoperative pain control, reduces opioid requirements, and enhances surgeon satisfaction and early recovery quality without increasing adverse events, but does not reduce CPSP incidence.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"592329"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Central Sensitization in Responsiveness to Brain Stimulation for Patients with Nonspecific Chronic Low Back Pain - An Exploratory Study.","authors":"Sharon Wang-Price, Jason Zafereo, Khalid Alkhathami, Yousef Alshehre, Hui-Ting Goh","doi":"10.2147/JPR.S590522","DOIUrl":"https://doi.org/10.2147/JPR.S590522","url":null,"abstract":"<p><strong>Purpose: </strong>This exploratory study aimed to examine (1) the effects of a single session of repetitive transcranial magnetic stimulation (rTMS) on pain thresholds in patients with high vs. low central sensitization (CS) levels, and (2) whether individuals with high vs. low CS levels exhibit different cortical excitability responses to rTMS compared with age- and sex-matched asymptomatic controls.</p><p><strong>Patients and methods: </strong>Twenty participants who had low back pain (LBP) for longer than 6 months were dichotomized into the high CS group (n = 10) and the low CS group (n = 10) using a Central Sensitization Inventory cutoff score of 33.5. In addition, 16 age- and sex-matched asymptomatic controls (8 for each CS group) were enrolled. Outcome measures, including pressure pain threshold (PPT), thermal pain threshold, and motor evoked potential (MEP) were collected before and after a single session of rTMS (10 Hz, 10-second pulse trains with a 50-second inter-train interval for 20 minutes). Non-parametric statistics were performed for within-group and between-group comparisons with <i>p</i> < 0.05 for significance.</p><p><strong>Results: </strong>Only the high CS group had significantly improved PPTs after rTMS (<i>p</i> = 0.037), with a moderate effect size. The low CS group and both matched asymptomatic control groups had an increase of MEPs after rTMS, whereas the high CS group had a decrease of MEPs after rTMS, although none of these MEP changes were statistically significant.</p><p><strong>Conclusion: </strong>This study identifies a patient population that may benefit from rTMS for reduction of pressure sensitivity. The decreased sensitivity to pressure in participants with high levels of CS corresponded to a decrease of cortical excitability after rTMS, which was in contrast with the rTMS effects observed in participants with low levels of CS and asymptomatic controls.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"590522"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Can the Sedative and Analgesic Effects of Virtual Reality Technology Be More Precisely Assessed in Pediatric Dental Care? Methodological Insights from an Ongoing Randomized Controlled Trial [Letter].","authors":"Fei-Yi Zhao, Qiang-Qiang Fu, Jia-Yi Zhu","doi":"10.2147/JPR.S618223","DOIUrl":"https://doi.org/10.2147/JPR.S618223","url":null,"abstract":"","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"618223"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dissecting the Causal Pathway from Herpes Zoster to Postherpetic Neuralgia: A Multi-Stage Mendelian Randomization Study Implicating VZV-Specific IgE and Cerebrospinal Fluid Metabolites.","authors":"Jianjin Zhang, Yanhong Chen, Xingyu Li, Chaobo Feng, Jiapeng Li, Zhouyang Hu, Guoxin Fan, Xiang Liao","doi":"10.2147/JPR.S581884","DOIUrl":"https://doi.org/10.2147/JPR.S581884","url":null,"abstract":"<p><strong>Background: </strong>Postherpetic neuralgia (PHN) develops in 10-20% of herpes zoster (HZ) patients, yet the causal mechanisms driving this transition from acute infection to chronic neuropathic pain remain elusive. VZV-specific immunoglobulin E (IgE) and cerebrospinal fluid (CSF) metabolites represent candidate intermediate phenotypes that may mediate neuroimmune dysfunction, but their sequential causal relationships remain unexplored. We hypothesized that IgE and CSF metabolites constitute a hierarchical causal pathway from HZ exposure to PHN risk.</p><p><strong>Methods: </strong>We conducted a multi-stage Mendelian randomization study. First, two-sample Mendelian Randomization (MR) with MRlap correction established causal effects of HZ on IgE and screened 435 CSF metabolites for PHN associations. Given substantial HZ-PHN sample overlap precluding total effect estimation, multivariable MR (MVMR) evaluated whether metabolites mediate IgE effects on PHN.</p><p><strong>Results: </strong>HZ exhibited a significant causal effect on VZV-specific IgE (IVW: β = 0.237, 95% CI: 0.104-0.371, <i>P</i> = 4.95×10^-4). Among 435 metabolites, two showed effects significant after FDR correction: 1-stearoyl-2-oleoyl-GPC (β = 2.448, FDR-adjusted P = 0.043) and N-methylproline (β = -0.425, FDR-adjusted P = 0.046). Critically, 5-methyluridine-nominally significant in univariable analysis (<i>P</i> = 0.095)-demonstrated a robust independent protective effect in MVMR (MV-IVW: β = -3.227, 95% CI: -5.765 to -0.688, FDR-adjusted P = 0.025; OR = 0.040). The IgE→PHN effect attenuated to non-significance (<i>P</i> = 0.202) upon adjusting for 5-methyluridine, consistent with metabolic mediation.</p><p><strong>Conclusion: </strong>These findings support a sequential causal pathway from HZ to PHN involving IgE and CSF metabolites, identifying 5-methyluridine as a potential modifiable protective factor and highlighting neuroimmune-metabolic crosstalk in chronic pain pathogenesis.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"581884"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dixon Up-and-Down Method for Optimizing Oxycodone Dosage in Painless Colonoscopy.","authors":"Yujie Ding, Chunliu Hou, Yan Li","doi":"10.2147/JPR.S591621","DOIUrl":"https://doi.org/10.2147/JPR.S591621","url":null,"abstract":"<p><strong>Aim: </strong>Inadequate analgesia during painless colonoscopy can result in undesirable body movements, undermining patient safety and procedural success. Oxycodone, known for its dual κ- and μ-receptor agonism, may provide effective analgesia with a reduced incidence of adverse effects compared to other opioids. However, the optimal intravenous dose of oxycodone for suppressing body movement during colonoscopy has not been established.</p><p><strong>Methods: </strong>This prospective, single-center, dose-finding study enrolled adult patients scheduled for painless colonoscopy. All participants received intravenous oxycodone in combination with propofol, with the oxycodone dose determined according to the Dixon and Massey up-and-down sequential allocation method. The primary outcome was the median effective dose (ED₅ ₀) of oxycodone required to suppress body movement during colonoscope insertion. Body movement was graded, and a positive response was defined as movement graded ≥2. The ED₅ ₀ was estimated as the mean of crossover midpoints after at least seven reversal pairs, and the 95% confidence interval (CI) was determined by probit regression. Adverse events within 20 minutes after the procedure, including agitation, abdominal pain, nausea or vomiting, dizziness or headache, and postural instability, were also recorded.</p><p><strong>Results: </strong>A total of 36 patients were enrolled. The calculated ED₅ ₀ of oxycodone for suppression of body movement during colonoscope insertion was 0.055 mg/kg, 95% CI: 0.047-0.063 mg/kg.</p><p><strong>Conclusion: </strong>Intravenous oxycodone, when dosed by the Dixon up-and-down method, is effective and safe for analgesia during painless colonoscopy.</p><p><strong>Clinical trial registration: </strong>ChiCTR:ChiCTR2300077446.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"591621"},"PeriodicalIF":2.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Beta and Gamma EEG Spectral Power as Independent Predictors of Acute Postoperative Pain in Spinal Surgery: A Prospective Observational Cohort Study.","authors":"Hui Wu, Meiyan Zhou, Songtao Liu, Yu Qi, Fan Zhou, Liwei Wang, Conghai Fan","doi":"10.2147/JPR.S593873","DOIUrl":"https://doi.org/10.2147/JPR.S593873","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this paper was to explore the relationship between preoperative EEG frequency band characteristics and postoperative acute pain in patients undergoing spinal surgery, in order to provide a scientific basis for personalized pain management.</p><p><strong>Methods: </strong>The study included 78 patients undergoing spinal surgery under general anesthesia. Two hours before surgery, the resting EEG of the patients was collected for 10 minutes with eyes closed and relaxed, and the power spectrum characteristics of different frequency bands were extracted by time-frequency analysis. Collected pain scores, anxiety and sleep scales of all patients before and after surgery. Combined with statistical analysis methods for data processing, the correlation between preoperative EEG frequency band power and postoperative pain was explored.</p><p><strong>Results: </strong>Our study revealed that preoperative beta and gamma power in patients undergoing spinal surgery were negatively correlated with postoperative pain and demonstrated significant predictive value for pain outcomes (β: <i>ρ</i> = -0.84, P<0.001; γ: <i>ρ</i> = -0.85, P<0.001). Notably, γ-band due to their specific association with the temporal-insular network, exhibited the most robust predictive efficacy. Furthermore, preoperative β-band and γ-band were also negatively correlated with postoperative anxiety and sleep quality.</p><p><strong>Conclusion: </strong>Preoperative β and γ oscillations represent promising neurophysiological correlates of acute pain susceptibility following spine surgery. Our findings suggest that these EEG metrics could serve as one of the components in a future multi-factorial predictive model for personalized pain management. However, given the multifactorial nature of pain and the lack of validated clinical thresholds, further research is required to establish their practical utility in guiding perioperative analgesic strategies. Future studies should focus on integrating these EEG biomarkers with psychological and clinical assessments to develop robust prediction tools.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"593873"},"PeriodicalIF":2.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salivary Substance P Levels During Cesarean Section Under Spinal versus General Anesthesia: A Prospective Study.","authors":"Ala A Alhowary, Omar Altal, Diab Bani Hani, Anas Alrusan, Atef F Hulliel, Rami K Jadallah, Rawhi Alshaykh, Tala Y Dabash, Ahmed H Al Sharie, Mohammad Al Hazaymeh","doi":"10.2147/JPR.S584688","DOIUrl":"https://doi.org/10.2147/JPR.S584688","url":null,"abstract":"<p><strong>Background: </strong>Substance P is a key neuropeptide involved in the transmission of nociceptive (pain) signals. The choice of anesthesia for childbirth, particularly for cesarean section (CS), is a critical decision that directly impacts the mother's physiological response to the procedure. This study aims to compare the levels of salivary SP in pregnant women undergoing CS under spinal versus general anesthesia.</p><p><strong>Methods: </strong>Eighty-three patients participated in this prospective comparative study. They were categorized into two groups: general and spinal anesthesia groups. The primary outcome was to measure the mean difference in salivary substance P level at three different time points of CS, and to compare these values between both groups. The secondary outcome was to assess the factors affecting the substance P levels in the mothers.</p><p><strong>Results: </strong>The study included 44 (53%) who received spinal anesthesia and 39 (47%) who received general anesthesia. Median substance P levels were significantly higher in the spinal anesthesia group (761 pg/mL [IQR 532-1335]) compared with the general anesthesia group (409 pg/mL [IQR 118-1094]; U = 1188.0, p = 0.0026). On multiple regression analysis, type of anesthesia was the independent variable influenced the levels of salivary substance P.</p><p><strong>Conclusion: </strong>This study demonstrates that participants receiving spinal anesthesia have significantly higher salivary substance P levels compared to those undergoing general anesthesia for CS. Further research is needed to understand the mechanisms underlying this observation and to determine its clinical implications for maternal and neonatal outcomes.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"584688"},"PeriodicalIF":2.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrograde Intrathecal Catheter Placement at L5/S1 for Sacropelvic Cancer Pain: A Pilot Feasibility Study.","authors":"James S Cho, Julia Zhu, Pritesh Topiwala, David Hao","doi":"10.2147/JPR.S589681","DOIUrl":"https://doi.org/10.2147/JPR.S589681","url":null,"abstract":"<p><strong>Background: </strong>Intrathecal drug delivery systems have a role in treating cancer pain. For patients with predominant sacropelvic pain, caudally directed retrograde catheter placement targeting L5/S1 represents an alternative strategy that has been less well described.</p><p><strong>Objective: </strong>This pilot study evaluated outcomes associated with retrograde intrathecal catheter placement in patients with refractory sacropelvic cancer pain, with a primary focus on systemic opioid reduction and discharge facilitation.</p><p><strong>Methods: </strong>This pilot retrospective, pre-post cohort study was conducted at two academic medical centers between January 2021 and September 2024. Seven patients with cancer-related sacropelvic pain who received a caudally directed (retrograde) intrathecal catheter with tip positioning at L5/S1 were included. Pre-intervention data, including pain scores and daily oral plus intravenous opioid requirement, were collected and compared (two-tailed paired <i>t</i>-test) with post-intervention data. Patients were followed for up to six months.</p><p><strong>Results: </strong>Systemic (oral plus intravenous) opioid use decreased substantially from a pre-intervention mean of 731.8 ± 515.8 mg oral morphine equivalents (OME) in the 24 hours prior to intrathecal delivery system placement to 195.9 ± 93.4 mg in the 24 hours prior to discharge (t = 3.112, <i>df</i> = 6, p = 0.02), a mean reduction of 535.9 OME (95% CI: 114.46 to 957.25). Mean pain scores showed a modest reduction from 5.94 ± 1.64 to 4.55 ± 1.62, which, while statistically significant, should be interpreted cautiously given the small sample and absence of a comparator group. All five hospitalized patients were discharged within one week of implantation.</p><p><strong>Conclusion: </strong>In this small retrospective pilot cohort, retrograde L5/S1 intrathecal catheter placement was associated with substantial systemic opioid reduction and discharge facilitation. Findings are exploratory and hypothesis-generating; prospective comparative studies are needed.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"19 ","pages":"589681"},"PeriodicalIF":2.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}