Narcotic analgesia: fentanyl reduces the intensity but not the unpleasantness of painful tooth pulp sensations.

Forty subjects rated the magnitude of painful electrical stimulation of tooth pulp before and after the intravenous administration of either fentanyl, a short-acting narcotic, or a saline placebo. The responses were choices of verbal descriptors from randomized lists of either sensory intensity (that is, weak, mild, intense) or unpleasantness (annoying, unpleasant, distressing) descriptors. The fentanyl significantly reduced the sensory intensity without reducing the unpleasantness of the tooth pulp stimuli, indicating that the mechanisms of narcotic analgesia may include a significant attenuation in pain sensation in addition to effects on pain reaction. These results stress the importance of using multiple measures of pain.

[1]  R. Dubner,et al.  Validity and sensitivity of ratio scales of sensory and affective verbal pain descriptors: Manipulation of affect by diazepam , 1978, Pain.

[2]  Ronald Dubner,et al.  Ratio scales of sensory and affective verbal pain descriptors , 1978, Pain.

[3]  R. Dubner,et al.  Neurons that subserve the sensory-discriminative aspects of pain , 1977, Pain.

[4]  L. Paul,et al.  Psychological and physiological mechanisms of pain. , 1977, Annual review of psychology.

[5]  Donald D. Price,et al.  Central nervous system mechanisms of analgesia , 1976, Pain.

[6]  G. Mower.  Perceived intensity of peripheral thermal stimuli is independent of internal body temperature. , 1976, Journal of comparative and physiological psychology.

[7]  H. Moskowitz,et al.  Effects of body weight and food intake on pleasantness ratings for a sweet stimulus. , 1976, Journal of applied physiology.

[8]  Richard L. Doty,et al.  An examination of relationships between the pleasantness, intensity, and concentration of 10 odorous stimuli , 1975 .

[9]  R. Melzack.  The McGill Pain Questionnaire: Major properties and scoring methods , 1975, PAIN.

[10]  H. L. Jacobs,et al.  Sugar Sweetness and Pleasantness: Evidence for Different Psychological Laws , 1974, Science.

[11]  B. W. Feather,et al.  Effects of Diazepam on Human Pain Tolerance and Pain Sensitivity , 1973, Psychosomatic medicine.

[12]  W. Torgerson,et al.  On the Language of Pain , 1971, Anesthesiology.

[13]  H. Beecher,et al.  Pain: one mystery solved. , 1966, Science.

[14]  H. Beecher,et al.  Objective evidence of mental effects of heroin, morphine and placebo in normal subjects. , 1962, The Journal of pharmacology and experimental therapeutics.

[15]  H. Beecher,et al.  Generalization from Pain of Various Types and Diverse Origins , 1959, Science.

[16]  H. Beecher.  Limiting factors in experimental pain. , 1956, Journal of chronic diseases.