A longitudinal study to evaluate pregnancy-induced endogenous analgesia and pain modulation

By: Carvalho B., Granot M., Sultan P., Wilson H., Landau R.
Published in: Regional Anesthesia and Pain Medicine
SDGs : SDG 03  |  Units: Social Welfare & Health Sciences  | Time: 2016 |  Link
Description: Background and Objectives: The phenomenon of pregnancyinduced analgesia has been demonstrated in animal models but less consistently in human studies. This study aimed to assess endogenous pain modulation, evaluating inhibitory and excitatory pain pathways, over the course of pregnancy and postpartum. Methods: Healthy pregnant women were approached for participation in this prospective multicenter cohort study. Conditioned pain modulation (CPM), mechanical temporal summation (mTS), and temperature that induced pain 6 out of 10 (pain-6) were assessed toward the end of each trimester of pregnancy (8-12, 18-22, and 36 weeks) and at 6 to 12 weeks postpartum. To assess how pregnancy affects CPM, mTS, and pain-6, a mixed-effects analysis of variance was performed. Results: Thirty-three pregnant women were enrolled. Pregnancy did not significantly impact CPM (F3,39 = 0.30, P = 0.83, partial η2 = 0.02), and therewas no significant difference between CPMscores in the third trimester compared with postpartum. The mTS scores and pain-6 ratings were also not significantly changed by pregnancy (F3,42 = 1.20, P = 0.32, partial η2 = 0.08; and F3,42 = 1.90, P = 0.14, partial η2 = 0.12, respectively). Conclusions: This is the first study to assess CPM and mTS changes in pregnancy and postpartum. Endogenous pain modulation evaluating both inhibitory and excitatory pain pathways did not significantly change during pregnancy or postpartum. Future studies are required to determine themagnitude and clinical significance of pregnancy-induced analgesia. Copyright © 2016 by American Society of Regional Anesthesia and Pain Medicine.