Pain Clinical Trial
Official title:
The Effect of Pregnancy on Temporal Summation and Venipuncture Pain Perception
Recent studies have shown that women are more likely to experience pain in many medical
situations. During pregnancy, women may experience an increase in pain threshold. This is
thought to be related to hormonal changes and an increase in the level of certain natural
pain-relieving substances in their bodies.
It is important to develop simple tests to identify woman at higher risk for pain so the
investigators can help them.
Temporal summation is what happens when a person becomes more sensitive to a certain feeling
on their skin when it is applied several times over the course of several seconds. The
investigators hypothesize that pregnant women show decreased temporal summation and pain
scores to venipuncture, compared to non-pregnant women.
Recent epidemiologic studies have shown that women are at substantially greater risk for
many clinical pain conditions, and there is a suggestion that postoperative and procedural
pain may be more severe among women then men. During pregnancy, women experience an
elevation in the threshold to pain and discomfort. In addition to hormonal changes, the
changes in pain perception during pregnancy may be related to an increase in endogenous
opioids.
Pain is the most feared experience in the intra and postpartum period, and severe pain
experienced during this time can lead to significant morbidity, including chronic pain and
depression. Much attention has been paid to tests that can predict patients at higher risk
for pain. Temporal summation (TS) has been shown to be a simple and reliable test. Temporal
summation represents the physiological wind-up phenomenon taking place at the spinal level
of the central pain pathways. TS extent can be measured in humans by administering a series
of noxious stimuli of constant intensity and of various modalities in order to evoke an
increase in perceived pain. It is a very simple and easy test to perform, and very well
tolerated by patients. Whether TS changes in pregnancy and whether TS in pregnancy
correlates with pain perception during acute stimuli such as venipuncture is unknown.
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Observational Model: Cohort, Time Perspective: Prospective
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