Document Detail


The relationship between resting blood pressure and acute pain sensitivity: effects of chronic pain and alpha-2 adrenergic blockade.
MedLine Citation:
PMID:  17940860     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study tested for alpha-2 adrenergic mediation of the inverse relationship between resting blood pressure and acute pain sensitivity in healthy individuals. It also replicated limited prior work suggesting this inverse blood pressure/pain association is altered in chronic pain, and provided the first test of whether chronic pain-related changes in alpha-2 adrenergic function contribute to these alterations. Resting blood pressure was assessed in 32 healthy controls and 24 chronic low back pain participants prior to receiving placebo or an intravenous alpha-2 adrenergic receptor antagonist (yohimbine hydrochloride, 0.4 mg/kg) in a randomized crossover design. Participants experienced three acute pain tasks during both sessions. A significant Systolic Blood Pressure x Participant Type x Drug interaction on finger pressure McGill Pain Questionnaire-Sensory ratings (P < .05) reflected significant hyperalgesic effects of yohimbine in chronic pain participants with lower systolic blood pressures (P < .05) but not those with higher systolic pressures, and no significant effects of yohimbine in controls regardless of blood pressure level. A Drug x Systolic Blood Pressure interaction on finger pressure visual analog scale unpleasantness indicated the inverse blood pressure/pain association was significantly stronger under yohimbine relative to placebo (P < .05). Significant Participant Type x Systolic Blood Pressure interactions (P's < .05) were noted for finger pressure visual analog scale pain intensity and unpleasantness, ischemic pain threshold, and heat pain threshold, reflecting absence or reversal of inverse blood pressure/pain associations in chronic pain participants. Results suggest that blood pressure-related hypoalgesia can occur even when alpha-2 adrenergic systems are blocked. The possibility of upregulated alpha-2 adrenergic inhibitory function in chronic pain patients with lower blood pressure warrants further evaluation.
Authors:
Stephen Bruehl; Ok Y Chung; Laura Diedrich; André Diedrich; David Robertson
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2007-10-17
Journal Detail:
Title:  Journal of behavioral medicine     Volume:  31     ISSN:  1573-3521     ISO Abbreviation:  J Behav Med     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-04-08     Completed Date:  2009-04-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7807105     Medline TA:  J Behav Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  71-80     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Vanderbilt University School of Medicine, 701 Medical Arts Building, 1211 Twenty-First Avenue South, Nashville, TN 37212, USA. Stephen.Bruehl@vanderbilt.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adrenergic alpha-Antagonists / administration & dosage*
Adult
Blood Pressure / physiology*
Chronic Disease
Cross-Over Studies
Double-Blind Method
Female
Fingers
Hot Temperature
Humans
Hyperalgesia / physiopathology
Male
Middle Aged
Pain / physiopathology*
Pressure
Receptors, Adrenergic, alpha-2 / antagonists & inhibitors*,  physiology
Yohimbine / administration & dosage*
Young Adult
Grant Support
ID/Acronym/Agency:
M01 RR-00095/RR/NCRR NIH HHS; NS046694/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Adrenergic alpha-Antagonists; 0/Receptors, Adrenergic, alpha-2; 146-48-5/Yohimbine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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