title: Short-term pre- and post-operative stress prolongs incision-induced pain hypersensitivity without changing basal pain perception.
abstract: BACKGROUND
  Chronic stress has been reported to increase basal pain sensitivity and/or exacerbate existing persistent pain. However, most surgical patients have normal physiological and psychological health status such as normal pain perception before surgery although they do experience short-term stress during pre- and post-operative periods. Whether or not this short-term stress affects persistent postsurgical pain is unclear.
  
  
  RESULTS
  In this study, we showed that pre- or post-surgical exposure to immobilization 6 h daily for three consecutive days did not change basal responses to mechanical, thermal, or cold stimuli or peak levels of incision-induced hypersensitivity to these stimuli; however, immobilization did prolong the duration of incision-induced hypersensitivity in both male and female rats. These phenomena were also observed in post-surgical exposure to forced swimming 25 min daily for 3 consecutive days. Short-term stress induced by immobilization was demonstrated by an elevation in the level of serum corticosterone, an increase in swim immobility, and a decrease in sucrose consumption. Blocking this short-term stress via intrathecal administration of a selective glucocorticoid receptor antagonist, RU38486, or bilateral adrenalectomy significantly attenuated the prolongation of incision-induced hypersensitivity to mechanical, thermal, and cold stimuli.
  
  
  CONCLUSIONS
  Our results indicate that short-term stress during the pre- or post-operative period delays postoperative pain recovery although it does not affect basal pain perception. Prevention of short-term stress may facilitate patients' recovery from postoperative pain.
authors.affiliation: Department of Anatomy, College of Basic Medicine, Zhengzhou University, Zhengzhou, 450001, Henan, China. caojing73@126.com.|Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, 185 S. Orange Ave., MSB, F-548, Newark, NJ, 07103, USA. caojing73@126.com.
authors.forename: Jing
authors.initials: J
authors.lastname: Cao
authors.affiliation: Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, 185 S. Orange Ave., MSB, F-548, Newark, NJ, 07103, USA. pk8511034@yahoo.com.tw.|Department of Anesthesiology, Buddhist Tzu Chi General Hospital, Institute of Medical Sciences, School of Medicine, Tzu Chi University, Hualien, Taiwan. pk8511034@yahoo.com.tw.
authors.forename: Po-Kai
authors.initials: PK
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA. vinodtiwari1980@gmail.com.
authors.forename: Vinod
authors.initials: V
authors.lastname: Tiwari
authors.affiliation: Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, 185 S. Orange Ave., MSB, F-548, Newark, NJ, 07103, USA. ll621@njms.rutgers.edu.
authors.forename: Lingli
authors.initials: L
authors.lastname: Liang
authors.affiliation: Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, 185 S. Orange Ave., MSB, F-548, Newark, NJ, 07103, USA. lutbriamar@gmail.com.
authors.forename: Brianna Marie
authors.initials: BM
authors.lastname: Lutz
authors.affiliation: Department of Physiology, School of Medicine, Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan. krshieh@mail.ttu.edu.tw.
authors.forename: Kun-Ruey
authors.initials: KR
authors.lastname: Shieh
authors.affiliation: Department of Anatomy, College of Basic Medicine, Zhengzhou University, Zhengzhou, 450001, Henan, China. zwd@zzu.edu.cn.
authors.forename: Wei-Dong
authors.initials: WD
authors.lastname: Zang
authors.affiliation: Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, 185 S. Orange Ave., MSB, F-548, Newark, NJ, 07103, USA. kaufmaga@njms.rutgers.edu.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Kaufman
authors.affiliation: Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, 185 S. Orange Ave., MSB, F-548, Newark, NJ, 07103, USA. bekkeray@njms.rutgers.edu.
authors.forename: Alex
authors.initials: A
authors.lastname: Bekker
authors.affiliation: Department of Anatomy, College of Basic Medicine, Zhengzhou University, Zhengzhou, 450001, Henan, China. gxq@zzu.edu.cn.
authors.forename: Xiao-Qun
authors.initials: XQ
authors.lastname: Gao
authors.affiliation: Department of Anatomy, College of Basic Medicine, Zhengzhou University, Zhengzhou, 450001, Henan, China. yt211@njms.rutgers.edu.|Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, 185 S. Orange Ave., MSB, F-548, Newark, NJ, 07103, USA. yt211@njms.rutgers.edu.
authors.forename: Yuan-Xiang
authors.initials: YX
authors.lastname: Tao
mesh_terms: D000818:Animals; D003345:Corticosterone / Q000097:blood; D005260:Female; D006727:Hormone Antagonists / Q000494:pharmacology; D006801:Humans; D008297:Male; D015735:Mifepristone / Q000494:pharmacology; D023421:Models, Animal; D058748:Pain Perception / Q000502:physiology*; D017288:Pain Threshold / Q000502:physiology*; D010149:Postoperative Pain / Q000503:physiopathology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D012149:Restraint, Physical; D013312:Stress, Physiological; D013315:Stress, Psychological
chemical_list: D006727:Hormone Antagonists; D015735:Mifepristone; D003345:Corticosterone