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A novel human surrogate model of noninjurious sharp mechanical pain

Shabes, Polinaa; Schloss, Nataliea; Magerl, Waltera; Schmahl, Christianb; Treede, Rolf-Detlefa; Baumgärtner, Ulfa,*

doi: 10.1097/j.pain.0000000000000352
Research Paper
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We propose a blade as a noninjurious nociceptive stimulus modeling sharp mechanical pain and yielding acute pain and hyperalgesia responses with closer proximity to incision-induced pain/hyperalgesia than punctate or blunt pressure mechanical pain models. Twenty-six healthy men and women were investigated to compare a small incision in the left forearm with noninvasive stimuli of different shapes and modalities to the right forearm. The magnitude and time course of incisional and blade-induced pain were assessed by numerical rating scales. Affective vs sensory components of pain experience were differentiated using a pain sensation questionnaire. The magnitude and time course of the axon reflex vasodilator response and of secondary hyperalgesia following a 7-second blade application were assessed. The maximum blade or incisional pain was similar (visual analogue scale [mean ± SD]: 32.9 ± 22.5 [blade] vs 33.6 ± 29.8 [incision]), and both time courses matched closely in the first 10 seconds (paired t test; P = 0.5-1.0), whereas incision but not blade was followed by a second phase of pain, probably related to the tissue injury (decrease to half maximum pain 8 ± 2 vs 33 ± 35 seconds; P < 0.01). Affective pain scores were significantly lower than sensory scores for all stimuli (P < 0.001). Comparing blade and incision, patterns of affective and sensory pain descriptors exhibited a remarkably similar pattern. Hence, we suggest the blade as novel model of sharp mechanical pain, which will be useful in investigating postoperative/mechanical pain and the role of self-injurious behavior in, eg, patients with borderline personality disorder.

The “blade” is a noninvasive surrogate model that imitates the acute phase of sharp incision-like pain. This model is useful to study mechanisms of mechanical pain and self-injurious behavior.

aDepartment of Neurophysiology, Centre of Biomedicine and Medical Technology Mannheim, Medical Faculty Mannheim, Ruprecht Karls-University Heidelberg, Mannheim, Germany

bDepartment of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany

Corresponding author. Address: Department of Neurophysiology, Centre of Biomedicine and Medical Technology Mannheim (CBTM), Medical Faculty Mannheim, Ruprecht Karls-University Heidelberg, Mannheim, Germany. Tel.: +49-621-383-9934; fax: +49-621-383-9921. E-mail address: ulf.baumgaertner@medma.uni-heidelberg.de (U. Baumgärtner).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Received March 09, 2015

Received in revised form July 24, 2015

Accepted August 31, 2015

© 2016 International Association for the Study of Pain
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