LACK OF ANALGESIC EFFECT OF OPIOIDS ON NEUROPATHIC AND IDIOPATHIC FORMS OF PAIN
LACK OF ANALGESIC EFFECT OF OPIOIDS ON NEUROPATHIC AND IDIOPATHIC FORMS OF PAIN
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DOI：
10.1016/0304-3959(88)90198-4
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发表时间：
1988-04-01
期刊：
影响因子：
7.4
通讯作者：
MEYERSON, BA
中科院分区：
文献类型：
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作者：
ARNER, S;MEYERSON, BA
本研究的目的是评估各种类型的慢性疼痛对静脉注射阿片类药物的反应性，并以双盲、随机的方式与安慰剂进行比较。吗啡或等效剂量的其他阿片类药物对原发性伤害性疼痛有明显的缓解作用（P > 0.001），而对神经性去传入疼痛无明显影响。此外，“特发性”疼痛，定义为慢性疼痛，没有或很少明显的病理，未能作出反应。结果与患者是否经常使用麻醉性镇痛药无关。我们的双盲阿片类药物试验的结果已被证明是有用的，以证明继续，或停止，在个别患者使用麻醉药物。它还可以支持侵入性刺激程序（脊髓或大脑）的适应症和选择。这项研究的结果说明了慢性疼痛作为一个实体的误解，并强调了认识不同的神经生物学机制和对镇痛药物以及非药理学治疗模式的反应差异的重要性。因此，阿片类药物测试已成为疼痛分析的一个有价值的工具，并有助于指导进一步的治疗。
The aim of the present study has been to assess the responsiveness of various types of chronic pain to opioids given i.v. and tested against placebo in a double-blind, randomized fashion. Pain classified as primary nociceptive was effectively alleviated (P > 0.001) while neuropathic deafferentation pain was not significantly influenced by morphine or equivalent doses of other opioids. Also ''idiopathic'' pain, defined as chronic pain with no or little demonstrable pathology, failed to respond. The results were not related to whether the patients were regular users of narcotic analgesics or not. The outcome of our double-blind opioid test has proved useful to justify a continued, or discontinued, use of narcotic medication in individual patients. It may also support the indication and choice of invasive stimulation procedures (spinal cord or brain). The results of the study illustrate the misconception of chronic pain as an entity and highlight the importance of recognizing different neurobiological mechanisms and differences in responsiveness to analgesic drugs as well as to non-pharmacological modes of treatment. The opioid test has thus become a valuable tool in pain analysis and helpful as a guide for further treatment.