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      Gender, genetics, and analgesia: understanding the differences in response to pain relief

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          Abstract

          Genetic variations and gender contribute significantly to the large interpatient variations in opioid-related serious adverse effects and differences in pain relief with other analgesics. Opioids are the most commonly used analgesics to relieve moderate-to-severe postoperative pain. Narrow therapeutic index and unexplained large interpatient variations in opioid-related serious adverse effects and analgesia negatively affect optimal perioperative outcomes. In surgical, experimental, chronic, and neuropathic pain models, females have been reported to have more pain than males. This review focuses on literature evidence of differences in pain relief due to multiple genetic variations and gender of the patient.

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          Most cited references 122

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          Endogenous pain control systems: brainstem spinal pathways and endorphin circuitry.

           A Basbaum,  H Fields (1983)
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            Studying sex and gender differences in pain and analgesia: a consensus report.

            In September 2006, members of the Sex, Gender and Pain Special Interest Group of the International Association for the Study of Pain met to discuss the following: (1) what is known about sex and gender differences in pain and analgesia; (2) what are the "best practice" guidelines for pain research with respect to sex and gender; and (3) what are the crucial questions to address in the near future? The resulting consensus presented herein includes input from basic science, clinical and psychosocial pain researchers, as well as from recognized experts in sexual differentiation and reproductive endocrinology. We intend this document to serve as a utilitarian and thought-provoking guide for future research on sex and gender differences in pain and analgesia, both for those currently working in this field as well as those still wondering, "Do I really need to study females?"
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              Sex differences in pain and pain inhibition: multiple explanations of a controversial phenomenon.

               Jeffrey Mogil (2012)
              A clear majority of patients with chronic pain are women; however, it has been surprisingly difficult to determine whether this sex bias corresponds to actual sex differences in pain sensitivity. A survey of the currently available epidemiological and laboratory data indicates that the evidence for clinical and experimental sex differences in pain is overwhelming. Various explanations for this phenomenon have been given, ranging from experiential and sociocultural differences in pain experience between men and women to hormonally and genetically driven sex differences in brain neurochemistry.
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                Author and article information

                Journal
                J Pain Res
                J Pain Res
                Journal of Pain Research
                Journal of Pain Research
                Dove Medical Press
                1178-7090
                2018
                08 November 2018
                : 11
                : 2729-2739
                Affiliations
                Department of Anesthesia, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA, ssadhasivam@ 123456iuhealth.org
                Author notes
                Correspondence: Senthilkumar Sadhasivam, Department of Anesthesia, Riley Hospital for Children at Indiana University Health, RH 2835, 705 Riley Hospital Drive, Indianapolis, IN 46202, USA, Tel +1 317 948 3845, Fax +1 317 944 0282, Email ssadhasivam@ 123456iuhealth.org
                Article
                jpr-11-2729
                10.2147/JPR.S94650
                6235329
                © 2018 Packiasabapathy and Sadhasivam. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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