Janssen Sabine A, Arntz Arnoud, Bouts Sabine
Department of Medical Psychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Pain. 1998 Jun;76(3):309-316. doi: 10.1016/S0304-3959(98)00060-8.
The role of peripheral epinephrine in the influence of anxiety on pain was investigated by intravenously infusing epinephrine and placebo in three increasing doses. The effect of epinephrine was measured within subjects on several subjective and autonomic measures: subjective pain, skin conductance response, heart rate response due to electrical stimulation, threshold for heat pain and threshold for pressure pain. Heat pain threshold was measured both on normal skin and on skin sensitized with capsaicin, since there is evidence that effects of sympathetic stimulation are only to be found in damaged or sensitized skin. Epinephrine caused a slight increase in subjective pain due to electrical stimulation and a decrease in heat pain threshold, which was larger on capsaicin-treated than on normal skin. However, heart rate response due to electrical stimulation and pressure pain threshold were not significantly influenced, while skin conductance response was even inhibited by epinephrine. Attentional focus, which was manipulated within electrical stimulation, seemed to have a much stronger influence on pain responses than pharmacological manipulation, independent of epinephrine. It may be speculated that, although evidence was found for effects of epinephrine on pain, they may be overruled by effects of attention.
通过静脉注射三种递增剂量的肾上腺素和安慰剂，研究了外周肾上腺素在焦虑对疼痛影响中的作用。在受试者体内测量肾上腺素对几种主观和自主神经指标的影响：主观疼痛、皮肤电反应、电刺激引起的心率反应、热痛阈值和压痛阈值。热痛阈值在正常皮肤和用辣椒素致敏的皮肤上均进行测量，因为有证据表明交感神经刺激的作用仅在受损或致敏的皮肤中才能发现。肾上腺素导致电刺激引起的主观疼痛略有增加，热痛阈值降低，辣椒素处理的皮肤比正常皮肤降低幅度更大。然而，电刺激引起的心率反应和压痛阈值未受到显著影响，而皮肤电反应甚至被肾上腺素抑制。在电刺激过程中操控的注意力焦点，似乎对疼痛反应的影响比药物操控更强，且与肾上腺素无关。可以推测，尽管发现了肾上腺素对疼痛有影响的证据，但它们可能会被注意力的影响所推翻。
