改进三测单在创伤病房疼痛记录中的临床应用研究

Objective To investigate the effect of improved three-item nursing recording sheet on simplifying nursing record and pain management in trauma ward. Methods The patients involved two wards in our department were divided into control group and study group. Control group was adopted conventional nursing recording sheet to record pain information with words. In study group, the improved three - item nursing recording sheet added pain scoring column was used to record pain information through the curve form. The effect, satisfaction of pain control and nursing record costing time were compared between two groups. Results Satisfaction of patients in study group was better than control group ( P＜0.05 ) ; The effect of pain control in study group wassignificantly better than control group (P＜0.001 ) ; The time of nurse recording was reduced one-third. Conclusions The improved recording sheet can make doctors and nurses visually, dynamically know pain intensity and trends, make patients receive timely and effective treatment, promote patient satisfaction with pain control, save recording time. This method is suitable for the surgical department.     

A preliminary trial of extracorporeal shock waves for the treatment of ⅢB chronic prostatitis

Objective To assess the effect of extracorporeal shock waves(ESWs)as a treatment for ⅢB chronic prostatitis(CP).Methods Forty-six men with ⅢB CP were randomly divided into an experimental group (n=34)and a control group(n=12).The patients in experimental group received low energy ESW treatment,20000 impulses in 10 sessions over 2 weeks.The patients in control group received sham ESW treatment without shock waves energy under the same other conditions as in experimental group.Pain,urination and quality of life/impact were assessed with National Institutes of Health-chronic prostatitis symptom index(NIH-CPSI).Both groups were assessed at baseline,post-treatment and at a 4-week follow-up.Resuits The total NIH-CPSI scores,pain scores and quality of life/impact scores in experimental group decreased significantly post-treatment(P＜0.01),but urination scores did not(P＞0.05).Similar decreases of these scores were also found in control group post-treatment.The total NIH-CPSl scores and pain scores maintained at a lower level at the 4-week follow-up in experimental group,but the scores returned to the level as pre-treatment in control group.The effectiveness rates and prominent effectiveness rates in experimental group were significantly higher than those in control group post-treatment and at the 4-week follow-up(all P＜0.05). Conclusions ESWs was effective in the treatment for ⅢB CP.After ESWs treatment pain alleviated,symptoms reducea and quality of life improved.     

Efficacy of fascia iliaca compartment nerve block as part of multimodal analgesia after surgery for femoral bone fracture

BACKGROUND: Fascia iliaca compartment nerve block(FICNB) has been an established technique for postoperative analgesia after surgery for femoral bone fracture. FICNB is technically easy, effective for postoperative pain control after operation for femoral bone fracture and decreases the complications induced by systemic analgesic drugs. The severity of postoperative pain is affected by genetics, cultural and social factors across the world. In this study we assessed the efficacy of fascia iliaca compartment nerve block when it is used as part of multimodal analgesia after surgery for femoral bone fracture.METHODS: An institution-based case control study was conducted from September, 2013 to May, 2014. All patients who had been operated on under spinal anesthesia for femoral bone fracture were included. The patients divided into a FICNB group(n=20) and a control group(n=20). The FICNB group was given 30 mL of 0.25% bupivacaine at the end of the operation. Postoperative pain was assessed within the f irst 24 hours, i.e. at 15 minutes, 2 hours, 6 hours, 12 hours and 24 hours using 100 mm visual analogue scale(VAS), total analgesic consumption, and the time for the f irst analgesic request.RESULTS: VAS pain scores were reduced within the f irst 24 hours after operation in the FICNB group compared wtih the control group. VAS scores at 2 hours were taken as median values(IQR) 0.00(0.00) vs.18.00(30.00), P=0.001; at 6 hours 0.00(0.00) vs. 34.00(20.75), P=0.000; at 24 hours 12.50(10.00) vs. 31.50(20.75), P=0.004; and at 12 hours(17.80±12.45) vs.(29.95±12.40), P=0.004, respectively. The total analgesic consumption of diclofenac at 12 and 24 hours was reduced in the FICNB group, and the time for the fi rst analgesic request was signifi cantly prolonged(417.50 vs. 139.25 minutes, P=0.000).CONCLUSIONS: A single injection for FICNB could lead to postoperative pain relief, reduction of total analgesic consumption and prolonged time for the fi rst analgesic request in the FICNB group after surgery for femoral bone fracture. We recommend FICNB for analgesia after surgery for femoral bone fracture and for patients with femoral bone fracture at the emergency department.     

老年静脉输液患者拔针前用复合碘去除胶贴粘性的临床观察

目的 研究老年静脉输液患者拔针前用复合碘去除胶贴粘性的临床效果.方法 采用自身前后对照的方法,对90例老年静脉输液患者行手背输液后拔针,每例自身对照各2次.对照组采用输液完后从胶贴一侧剥离到另一侧再拔针的方法;观察组采用输液完后拿蘸复合碘消毒液的棉枝在胶贴与皮肤之间分别从胶贴两边轻轻擦向穿刺针口去除胶贴粘性,再拔针的方法.结果 观察组和对照组患者疼痛率分别为18.33%、90.56%(P＜0.01),皮下出血率分别为5.56%、16.11%(P＜0.01),皮肤破损率分别为0%、4.00%(P＜0.01).结论 输液完后拿蘸复合碘消毒液的棉枝先消除胶贴粘性后剥除,再拔针的方法能减少患者疼痛及皮下瘀血,避免皮肤破损,缓解患者对输液的恐惧感,增加静脉血管的可重复穿刺机会.

Abstract：

Objective To investigate the effect of iodine compound removing glue before pulling out infusion in old venous transfusion patients. Methods There were 90 elderly cases of intravenous infusion with back of the hand infusion needle injection were investigated. The control group was treated with fluids exhausted from the glue side to the other side; observation group was treated with iodine compound. Results The pain rates of observation group and control group were 18. 33%, 90.56% (P ＜0.01 ), the subcutaneous hemorrhage rates were 5.56%, 16. 11% ( P ＜ 0. 01 ), the skin damage rates were as follows 0, 4. 00% (P ＜ 0. 01 ) . Conclusions The method of removing glue before pulling out infusion can reduce the patients'pain and subcutaneous bleeding, to avoid skin damage, ease the fear of transfusion patients, maintain the repeated puncture opportunity of the blood vessels.     

改进三测单在创伤病房疼痛记录中的临床应用研究

Objective To investigate the effect of improved three-item nursing recording sheet on simplifying nursing record and pain management in trauma ward. Methods The patients involved two wards in our department were divided into control group and study group. Control group was adopted conventional nursing recording sheet to record pain information with words. In study group, the improved three - item nursing recording sheet added pain scoring column was used to record pain information through the curve form. The effect, satisfaction of pain control and nursing record costing time were compared between two groups. Results Satisfaction of patients in study group was better than control group ( P＜0.05 ) ; The effect of pain control in study group wassignificantly better than control group (P＜0.001 ) ; The time of nurse recording was reduced one-third. Conclusions The improved recording sheet can make doctors and nurses visually, dynamically know pain intensity and trends, make patients receive timely and effective treatment, promote patient satisfaction with pain control, save recording time. This method is suitable for the surgical department.     

早期护理干预对改善二氧化碳气腹腹腔镜术后肩部疼痛的效果观察

目的 探讨早期护理干预对预防CO2气腹腹腔镜手术引起的肩部疼痛的效果观察.方法 选择2009年1月～2011年1月在妇科经CO2气腹腹腔镜手术患者100例,随机分为干预组和对照组,每组50例.干预组患者在术前教会早期护理干预的技巧,手术返病房后即进行早期护理干预,而对照组按常规护理干预.结果 干预组肩部疼痛较对照组少且轻(P＜0.05).结论 早期护理干预可显著降低妇科CO2气腹腹腔镜手术后引起的肩部疼痛.

Abstract：

Objective To explore the effect of early nursing intervention on shoulder pain caused by carbon dioxide pneumoperitoneum laparoscqpy.Methods A total of 100 patients were selected in gynecology department from January 2009 to January 2010.They were divided into intervention group and control group, each group had 50 cases.Patients in intervention group were taught the early nursing intervention skills before laparoscopy and were treated with it at once after laparoscopy, meanwhile, the patients in control group were treated with conventional nursing intervention.Results The shoulder pain of the intervention group was (P ＜ 0.05 ) fewer and slighter than that of control group.Conclusions The earlynursing intervention can significantly reduce the shoulder pain caused bycarbon dioxide pneumoperitoneum laparoscopy.     

君蟾纱条用于痔术后创面愈合的临床观察

目的 探讨君蟾纱条用于痔术后创面愈合的疗效.方法将180例痔疮手术患者采用完全随机分组法分为观察组和对照组各90例,观察组于术后每日用君蟾纱条纳于肛管及肛门创面上,对照组用九华膏常规换药.比较2组的临床效果.结果观察组在减轻术后创口疼痛、出血和水肿等方面均显著优于对照组,其平均住院时间及创面愈合时间也显著短于对照组.结论君蟾纱条能有效地减轻痔术后创面疼痛、出血、水肿症状,促进创面愈合,缩短住院天数,减轻患者的痛苦.

Abstract：

Objective To discuss the effect of Jun laevis gauze on wound healing after hemorrhoids surgery. Methods 80 patients after hemorrhoids surgery were randomly divided into the control group and the observation group with 90 patients in each group. The observation group was applied with the Jun laevis gauze in the anal canal and anus everyday, the control group received Kau cream dressing change. The clinical effect was compared between the two groups. Results The observation group was significantly better than the control group in reducing postoperative wound pain, hemorrhage and edema, the average length of hospital stay and wound healing time was significantly shorter than the control group. Conclusions Jun toad gauze can alleviate hemorrhoid pain, bleeding, edema, symptoms, and promote wound healing, shorten hospital stays and reduce patient suffering.     

助产士组人员为孕妇提供连续性护理的效果评价

目的 探讨助产士组人员为孕妇提供连续性护理的效果.方法 将筛选的100例孕妇随机分为研究组和对照组各50例,研究组按照助产士组人员提供连续性护理的要求服务;对照组按照传统护理模式服务,比较不同护理措施对母婴的效果.结果 研究组孕产妇对产前认知行为的依从性高,自然分娩率高,母乳喂养率升高,孕产妇满意度提高,新生儿窒息率降低,产后抑郁症的发生率低,与对照组相比差异显著.结论 助产士组人员提供连续性护理能提高孕妇对产前认知、自然分娩率、母乳喂养率、产妇满意度、护理人员的综合素质,降低新生儿窒息率,减少产后抑郁症发生,提高了围生期保健质量.

Abstract：

Objective To investigate the effect of continuous care provided by midwife group personnel to pregnant women.Methods 100 cases of pregnant women were screened out and divided into the study group and the control group with 50 patients in each group randomly.The study group received continuous care provided by midwife group personnel,the control group received traditional nursing.Effect of different nursing measures on mothers and neonates were compared.Results Antenatal cognition and rate of natural delivery of the study group were higher than the control group.The rate of neonatal asphyxia and postpartum depression occurred in the study group were lower than the control group,Maternal and family sarisfaction and rates of breasffeeding of the study group were higher than the control group.Conclusions Continuoas care provided by midwife group personnel can increase antenatal cognition and rate of natural delivery,maternal and family satisfaction.breast feeding rates and the overall quality of nursing staff,reduce rate of neonatal asphyxia with few postpartum depression,then improve the quality of perinatal care.     

生脉注射液对血透相关性低血压患者的疗效观察

Objective To observe clinical effect of Shengmai injection on dialysis-related hypotension.Methods Seventy patients with dialysis-related hypotension were divided into two groups:experimental group (35 cases)and control group (35 cases). Patients in experimental group was treated with Shengmai injection,while patients in control group were given with conventional treatments. Effective rate and hemodynamics changes were measured in both groups. Results The effective rate in experimental group was significantly higher than control group (P＜ 0.05), while frequency of treatment was lower than control group (P＜ 0. 05). There were no significant difference between experimental group and control group in systolic pressure, diastolic pressure and heart rate (P ＞ 0.05). Conclusion Shengmai injection is effective and safe in dialysis-related hypotension.     

腹股沟疝无张力修补术后谵妄的相关因素分析及护理

Objective To analyze the correlation factors and to explore the care measures of postopera-tive delirium in elderly patients with tension - free inguinal hernia repairing. Methods 185 cases of elderly pa-tients with tension - free inguinal hernia repairing were analyzed by single - factor analysis and multi - factor logis-tic regression analysis. Results 24 cases of patients with delirium was delirium group, 161 cases who had not de-lirium was non - delirium group. The average age of delirium group, surgical time, the degree of postoperative wound pain, and the incidence of lumbodynia, the original brain heart and lung disease, dysuria, constipation, postoperative use of analgesics were significantly higher than those of non - delirium group (P<0.01～0.05) . Conclusions The occurrence of postoperative delirium in elderly patients with tension -free inguinal hernia re-pairing is correlated with age, operative time, postoperative pain, heart disease, lung disease, brain disease, dys-uria, constipation, postoperative use of analgesics, degree of postoperative wound pain.     

Iontophoresis versus subcutaneous injection: a comparison of two methods of local anesthesia delivery in children

The relative efficacy of local lidocaine anesthesia administered by subcutaneous injection and by iontophoresis was studied in 13 pediatric renal dialysis patients (ages 11-19 years: mean age 15.8 years). Each patient served as his own control at 3 assessment periods. Each type of anesthetic delivery method was administered to either of 2 fistula sites. Patients used visual analogue scales to rate pain, anxiety, and satisfaction for each method. Behavioral observations were made by an observer and a nurse. Paired sample t tests were used to compare the 2 drug delivery methods for patient, observer, and nurse ratings across assessment periods. There were no significant differences between methods for ratings of anxiety before or during the procedure. The injection of lidocaine was rated as more painful by the observer and nurse (with a trend for patients) than the use of iontophoresis. But, the patients and nurse rated the injection method as more effective. Iontophoresis was never rated as superior to the injection method, even after turning over control of drug delivery by iontophoresis to the patient (sessions 2 and 3). Patients were more satisfied with iontophoresis at session 2 when they took over control, but lost enthusiasm by session 3. Three subjects withdrew from the study due to cutaneous burns and prolonged anesthesia delivery time with iontophoresis. Iontophoresis appears to be effective in reducing the pain of dialysis needle insertion but requires further investigation before it can be considered a viable alternative to subcutaneous injection.     

拇趾甲沟炎拔甲术中局部麻醉方法的改进

目的观察两种局部麻醉方法在拇趾甲沟炎拔甲术中的应用效果。方法将2010年6月至2011年10月在解放军总医院门诊外科行单侧部分拔甲术的72例拇趾甲沟炎患者随机分为研究组和对照组各36例,研究组采用甲根上局部浸润麻醉后实施拔甲术,对照组采用趾根神经阻滞麻醉后实施拔甲术;比较两组患者的麻醉效果、麻醉剂用量、麻醉时间及拔甲术全程操作时间。结果两种局部麻醉方法的的注药时间及手术过程中的疼痛评分差异无统计学意义(P>0.05);研究组麻醉剂用量少于对照组,麻醉时间及拔甲术全程操作时间短于对照组,差异均有统计学意义(均P<0.01)。结论拇趾甲沟炎拔甲患者采用甲根上局部浸润麻醉可达到满意的麻醉效果,且麻醉剂用量少、麻醉及手术时间短,是一种更加安全有效的局部麻醉方法。     

Does the Use of Topical Lidocaine,Epinephrine, and Tetracaine Solution Provide Sufficient Anesthesia for Laceration Repair?

Objective: To determine: 1) the effectiveness of lidocaine, epinephrine, and tetracaine (LET) solution in eliminating or reducing the pain experienced in suturing superficial lacerations in adult patients; and 2) the effectiveness of LET in reducing the pain of local anesthetic injection.
Methods: A prospective, randomized, double-blind study in which 60 adult patients with superficial lacerations were entered was conducted in the ED of a community-based teaching hospital affiliated with the University of Toronto. Following application of the LET or placebo (sterile water) solution to the laceration, a visual analog pain scale was recorded by the patient upon needle probing of the wound margin. If probing was painless, the laceration was repaired using LET alone. If injection of local anesthetic was required, an additional pain scale was elicited to quantify the attenuation of the pain of injection by the prior application of LET.
Results: Pain scale values on needle probing were significantly reduced in the LET group vs the placebo group (medians of 4.0 vs 5.0 cm, respectively; p < 0.05). Only 13 of the 30 patients in the LET group required additional anesthetic, while all 30 patients in the placebo group requested local anesthetic. Pain scale values on injection of local anesthetic were not significantly different between the LET and placebo groups (medians of 3.5 vs 5.0 cm, respectively; p = 0.09), although there was a trend for lower pain scale values for those patients who received LET. No adverse effects were noted after the application of either LET or placebo solution. Follow-up was achieved for 54 of 60 patients with only 1 complication (a wound infection) reported in the LET group.
Conclusions: Significantly fewer patients require an injectable anesthetic when LET is applied. Those who do require an injection may experience less discomfort. These advantages should be balanced against the 20 to 30 minutes necessary for the LET to take effect.     

Are Diagnostic Lumbar Facet Injections Influenced by Pain of Muscular Origin?

Introduction: Nonradicular low back pain can be a difficult entity to accurately diagnose and treat. Facet joints, muscle, ligaments, and fascia have all been reported to be etiologies of acute and chronic low back pain. However, the facet joint as a source of low back pain is controversial. The diagnosis of facet joint pain is made by diagnostic facet joint or median nerve branch injections with a local anesthetic. The purpose of this study was to determine if the results of diagnostic facet joint injections are influenced by the technique used to perform these injections. Methods: Seventy‐five male patients aged 45 years or younger and 18 years or older who were injured while performing heavy work with nonradicular low back pain were included in this study. Diagnostic injection therapy was performed following Institutional Review Board approval and the patient's informed consent. Patients were assigned to one of five groups to receive diagnostic injections in a double‐blinded fashion as follows: Group I: facet joint injection with continuous lidocaine administration from the skin to the facet joint as the needle was advanced; Group II: facet joint injection with saline administration from the skin to the facet joint as the needle was advanced; Group III: median nerve branch injection with a lidocaine advancing needle technique; Group IV: median nerve branch injection with saline advancing needle technique; and Group V: injection of the paraspinous muscles with local anesthetic and steroid following noted areas of pain diagnosed with saline injection and radiopaque contrast. After one week, the patients in Groups I to IV who had no pain relief with facet joint or median nerve block injections subsequently received paraspinous muscle injections, while the patients in Group V who had no long‐term relief with muscle injections were given facet joint injections. The appropriate parametric and nonparametric tests were performed with statistical significance defined as P ≤ 0.05. Results: There were no differences among the groups demographically. The incidence of pain relief was significantly higher in subjects who had a continuous injection of local anesthetic into their musculature than in those individuals who received continuous saline followed by an injection of local anesthetic into their facet joint or median nerve branch. Discussion: The results of this study demonstrated that local anesthetic injections are useful for the diagnosis of nonradicular low back pain but may yield false positive results with respect to lumbar facet pain depending upon the technique utilized.     

Mode of delivery following labor epidural analgesia: influence of ropivacaine and bupivacaine.

Epidural analgesia is a popular and effective method for pain relief during labor. Bupivacaine is a commonly used local anesthetic for labor epidural analgesia. Ropivacaine is an amino acid local anesthetic that is structurally related to bupivacaine with a similar potency and duration, but ropivacaine has less cardiac toxicity than bupivacaine and produces less motor blockade. These properties make ropivacaine a desirable local anesthetic agent for obstetrical analgesia. The purpose of the present study was to compare the cesarean section and instrumental delivery rates for patients receiving labor epidural analgesia using bupivacaine and ropivacaine. The medical records of 500 consecutive patients receiving bupivacaine for labor epidural analgesia were reviewed. After a 3-month familiarization period for ropivacaine, the records of 500 consecutive patients receiving ropivacaine for labor epidural analgesia similarly were reviewed. The groups did not differ demographically. The instrumental delivery rate was 14.2% for the bupivacaine group and 9.8% for the ropivacaine group. The cesarean section rate was 14% for the bupivacaine group and 10.2% for the ropivacaine group. At our facility, the use of ropivacaine decreased both cesarean section and instrumental delivery rates when compared with bupivacaine in the population studied.     

Evaluation of vapocoolant spray effect on pain reduction during digital nerve block: A randomized clinical trial

IntroductionThe digital nerve block is an effective method of anesthesia before minor surgical interventions on the fingers. However, patients may experience a lot of pain and anxiety during this procedure. The efficacy of topical vapocoolant spray during minor procedures has been demonstrated in previous studies. we aimed to evaluate the effectiveness of topical vapocoolant spray in reducing pain during digital nerve block.MethodsThis prospective, randomized clinical study was conducted to evaluate the effectiveness of vapocoolant spray application in reducing pain during digital block. The patients were categorized into 2 groups as spray-treated and control group. A routine digital block process was applied to the control group. Spray application was performed in two groups of 50 each, in a manner of bilateral and unilateral to the finger. Demographic data of the patients, such as gender, age, dominant hand, injury patterns, injection site and injury sites, were recorded. After the application, the patients' visual analog scale (VAS) was evaluated.ResultsOf the participants, 100 were randomly assigned to the vapocoolant spray-treated group, and 50 were included in the control group. The VAS pain score during penetration in both spray groups was significantly lower than the control group (p < 0.001). Pain change during penetration was found to be significantly lower in the bilateral spray-treated group compared to the control group (p < 0.001). Pain change during infiltration was significantly lower in both spray groups compared to the control group (p < 0.001).ConclusionsSpray application prior to digital nerve blocking can be used to reduce needle penetration pain associated with this procedure and pain associated with local anesthetic infiltration.     

复方阿替卡因麻醉拔牙的临床观察

目的比较复方阿替卡因(必兰)、利多卡因在上颌前牙、前磨牙拔除的麻醉效果。方法选择100例患者的122颗患牙随机分为两组,分别进行局黏膜下(或黏骨膜下)浸润麻醉,对其麻醉注射时及拔牙时的疼痛程度进行比较分析。结果复方阿替卡因局部黏膜下浸润麻醉注射时疼痛明显小于利多卡因(P<0.01),拔牙时疼痛程度小于利多卡因,麻醉良好率为96.77%(P<0.01)。结论复方阿替卡因局部麻醉起效时间快,对组织的浸润性及局部渗透力强,浸润麻醉时安全,效果好,特别适合于普通牙槽外科治疗。     

阿替卡因肾上腺素注射液浸润麻醉在下颌智齿拔除中的应用

目的探讨阿替卡因肾上腺素注射液在下颌智齿拔除中的麻醉效果及安全性。方法将96例105颗智齿随机分为治疗组53例58颗牙和对照组43例47颗牙。治疗组采用阿替卡因肾上腺素注射液行局部浸润麻醉,对照组采用利多卡因注射液神经传导阻滞麻醉。比较2组麻醉效果、不良反应及并发症的情况。结果治疗组麻醉注射时视觉模拟评分（VAS）值与对照组比较差异有统计学意义（P〈0.05）,而拔牙操作中VAS值与对照组比较差异无统计学意义（P〉0.05）。治疗组麻醉良好率、总有效率分别为84.48%、100.00%,对照组分别为93.62%、100.00%,2组比较差异均无统计学意义（均P〉0.05）。除对照组1例出现血管损伤致局部血肿的并发症外,2组均未出现不良反应。结论拔除下颌智齿时,阿替卡因肾上腺素注射液黏膜下浸润麻醉可达到与利多卡因注射液神经阻滞麻醉相当的效果,而无不良反应及并发症。     

Pharmacological characterisation of the spared nerve injury model of neuropathic pain

Hypersensitivity after tissue injury is an expression of neuronal plasticity in the central nervous system. This has been explored most extensively using in vitro preparations and animal models of inflammatory pain and chemical irritation. For pain after surgery, a similar process has been proposed. In the present study, we examined dorsal horn neuron (DHN) sensitization using the plantar incision model for post-operative pain. In behavioral experiments, the effect of a local anesthetic injection (or saline vehicle) 15 min before plantar incision on pain behaviors several days after incision was studied. Bupivacaine injection before incision prevented pain behaviors until 4 h afterwards; injection after incision produced the same effect. One day after incision, pain behaviors were not different between rats injected with saline or bupivacaine. In neurophysiologic experiments, however, bupivacaine injection blocked activation of DHNs during incision. One hour after incision, expansion of receptive fields (RFs) to pinch and increased background activity occurred in 14 of 16 neurons in the saline group but only in two of 22 neurons in the bupivacaine group. The difference was not due to a systemic effect of bupivacaine. Ten sensitized neurons were studied using the injection of bupivacaine 90 min after incision. Increased background activity (n=7) and expanded RFs (n=7) were reversed by bupivacaine. Sensitization was re-established in seven of eight neurons 2 h after injection as the local anesthetic dissipated. These results indicate that activation of DHNs during plantar incision and sensitization 1 h later are not necessary for subsequent pain behaviors. Because sensitization was reversed 90 min after plantar incision and then re-established as the local anesthetic effect diminished, enhanced responsiveness of DHN requires ongoing afferent input during the first day after incision.