Models of Visceral Nociception

Pains arising from the viscera constitute a large portion of clinically treated pains. They are characterized by poor localization; immobility with tonic increases in muscle tone; and vigorous but nonspecific changes in autonomic function, such as changes in respiration, heart rate, and blood pressure. Tissue-damaging stimuli do not reliably produce visceral pain, so the study of visceral nociception in nonhuman animals requires identification of appropriate stimuli and responses. This article defines "noxious" visceral stimuli as those that produce pain in humans, result in aversive behaviors in animals, and evoke responses that are inhibited by manipulations known to be analgesic in humans. To be valid, the measured responses must be reliable, inhibited by known analgesics, and not inhibited by nonanalgesics. Using these criteria as measures of validity, the author examined several visceral pain models. The writhing test (application of intraperitoneal irritants) failed to meet these criteria; however, responses to small bowel distension, colonic-rectal distension, artificial ureteral calculosis, urinary tract distension, and the intravesical application of irritants met most, if not all, of the criteria. Other models, such as responses to biliary system distension, to reproductive organ stimulation, to the focal application of algesic agents onto various viscera, and to ischemic stimuli, met some of these criteria. This information should assist readers in decisions related to the use of visceral pain models.