Response expectancies in placebo analgesia and their clinical relevance
Response expectancies in placebo analgesia and their clinical relevance
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DOI：
10.1016/s0304-3959(01)00296-2
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发表时间：
2001-07-01
期刊：
影响因子：
7.4
通讯作者：
Benedetti, F
中科院分区：
文献类型：
--
作者：
Pollo, A;Amanzio, M;Benedetti, F
反应预期被认为是安慰剂效应的主要决定因素。在这里，我们报告说，不同的期望产生不同的镇痛效果，这反过来又可以利用在临床实践中。开胸患者应要求连续3天接受丁丙诺啡治疗，同时基础静脉输注生理盐水。然而，这种基础输注的象征意义在三个不同的患者组中发生了变化。第一组没有被告知任何止痛效果（自然史）。第二组被告知基础输注是：强效止痛药或安慰剂（经典的双盲给药）。第三组被告知基础输注是一种有效的止痛药（欺骗性给药）。因此。尽管三组的镇痛治疗完全相同，但关于基础输注的口头说明不同。通过记录3天治疗期间要求的丁丙诺啡剂量，测量生理盐水基础输注的安慰剂效应。我们发现，与自然史组相比，双盲组的丁丙诺啡需求减少。然而，这种减少在欺骗性管理组中更大。总的来说。在安慰剂输注3天后，第一组接受11.55mg丁丙诺啡。第二组9.15mg.第三组7.65mg.尽管存在这些剂量差异，但三组的镇痛效果相同。这些结果表明，不同的口头指示的某些和不确定的预期镇痛产品不同的安慰剂镇痛效果，这反过来又引发了一个戏剧性的行为变化，导致阿片类药物的摄入量显着减少。(C)2001 Elsevier Science B.V.由Elsevier Science B.V.出版。保留所有权利。
Response expectancies have been proposed as the major determinant of placebo effects. Here we report that different expectations produce different analgesic effects which in turn can be harnessed in clinical practice. Thoracotomized patients were treated with buprenorphine on request for 3 consecutive days, together with a basal intravenous infusion of saline solution. However, the symbolic meaning of this basal infusion was changed in three different groups of patients. The first group was told nothing about any analgesic effect (natural history). The second group was told that the basal infusion was: either a powerful painkiller or a placebo (classic double-blind administration). The third group was told that the basal infusion was a potent painkiller (deceptive administration). Therefore. whereas the analgesic treatment was exactly the same in the three groups, the verbal instructions about the basal infusion differed. The placebo effect of the saline basal infusion was measured by recording the doses of buprenorphine requested over the three-days treatment. We found that the double-blind group showed a reduction of buprenorphine requests compared to the natural history group. However, this reduction was even larger in the deceptive administration group. Overall. after 3 days of placebo infusion, the first group received 11.55 mg of buprenorphine. the second group 9.15 mg. and the third group 7.65 mg. Despite these dose differences, analgesia was the same in the three groups. These results indicate that different verbal instructions about certain and uncertain expectations of analgesia product different placebo analgesic effects, which in turn trigger a dramatic change of behaviour leading to a significant reduction of opioid intake. (C) 2001 Elsevier Science B.V. Published by Elsevier Science B.V. All rights reserved.