A search for sex differences in response to analgesia
A search for sex differences in response to analgesia
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DOI：
10.1001/archinte.160.22.3424
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发表时间：
2000-12-11
影响因子：
--
通讯作者：
Katzper, M
中科院分区：
文献类型：
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作者：
Averbuch, M;Katzper, M
背景：人们普遍认为，男性和女性对疼痛的反应不同。根据已发表的文献，除少数例外，女性表现出较低的疼痛阈值和对疼痛刺激的耐受性较低。文献中有一些支持，即给予麻醉性镇痛药后，女性的镇痛疗效高于男性。我们比较了镇痛反应的女性和男性布洛芬后第三磨牙拔除牙痛model.Methods：我们进行了荟萃分析，包括在布洛芬治疗组的7个双盲，后第三磨牙拔除牙痛（中度至重度）的研究，这是以电子方式提交给该机构的314个主题。所有研究的入选和排除标准几乎相同。疼痛缓解和疼痛强度测量在所有研究中使用相同的指标，并记录之前和至少在0.5，1.0，1.5，2.0，3.0，4.0，5.0和6.0小时后，药物administration.Results：该研究包括195名女性受试者和119名男性受试者（平均年龄，21岁）。除了需要拔牙外，受试者都很健康。女性患者术后基线疼痛程度高于男性患者，具有统计学显著性（P= 0.006）。疼痛强度和疼痛缓解评分在汇总数据集以及所有个体研究中均证明了ibugrofen的良好镇痛作用。此外，在给药后的任何时间点，雌性和雄性治疗组的平均疼痛强度和疼痛缓解评分随时间的变化均无显著差异，未对缺失值进行插补。使用“基线观察结转”技术的数据分析再用药的受试者（由食品和药物管理局推荐的急性镇痛药物的疗效分析的技术）产生了相同的结果，这证实了方差分析和t检验在每个时间点的study.Conclusions：我们的研究结果表明，没有性别对布洛芬的镇痛反应的影响。这些结果是在后第三磨牙拔除设置下获得的，其中存在最少可能的混杂因素。为了充分确定这种现象的普遍性，应该在其他疼痛模型中进行研究，并使用具有不同作用机制的镇痛药物。
Background: It is generally accepted that males and females respond differently to painful conditions. With few exceptions, according to the published literature, females demonstrate a lower pain threshold and a lower tolerance of painful stimuli. There is some support in the literature that females experience greater analgesic efficacy than do males after the administration of narcotic analgesics. We compared the analgesic response of females and males to ibuprofen in a post-third-molar extraction dental pain model.Methods: We performed a meta-analysis of 314 subjects included in the ibuprofen treatment arm of 7 double-blind, post-third-molar extraction dental pain (moderate to severe) studies, which were submitted to the agency electronically. The inclusion and exclusion criteria were practically identical in all studies. Pain relief and pain intensity measurements used the same metrics in all studies and were recorded just before and at least at 0.5, 1.0, 1.5, 2.0, 3.0, 4.0, 5.0, and 6.0 hours after drug administration.Results: The study included 195 female subjects and 119 male subjects (mean age, 21 years). Other than requiring dental extractions, the subjects were all healthy. Postoperative baseline pain was greater in females than males to a statistically significant degree (P=.006). Both pain intensity and pain relief scores demonstrated the well-established analgesic effect of ibugrofen in the pooled data set as well as in all the individual studies. Moreover, the mean pain intensity and pain relief scores over time for the female and male treatment groups were not noticeably different at any time point after drug administration, with no imputation for missing values. Analysis of the data using the "baseline observation carried forward" technique for remedicated subjects (the technique recommended by the Food and Drug Administration for efficacy analysis of acute analgesic medications) produced the same results, which were confirmed by analysis of variance and t tests at each time point of the study.Conclusions: Our results demonstrated no sex effect on the analgesic response to ibuprofen. These results were obtained under the post-third-molar extraction setting, in which the least possible confounding factors are present. To fully establish the generality of this phenomenon, studies should be carried out in other pain models and using analgesic medications with different mechanisms of action.