Opioid-induced hyperalgesia in community-dwelling adults with chronic pain.

Opioid-induced hyperalgesia in community-dwelling adults with chronic pain.
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DOI:
10.1097/j.pain.0000000000000170
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发表时间:
2015-06
期刊:
影响因子:
7.4
通讯作者:
Twyner C
Twyner C
中科院分区:
医学1区
文献类型:
--
作者:
Hooten WM;Lamer TJ;Twyner C

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长期使用阿片类药物对患有慢性疼痛的社区成年人的痛敏效应尚未得到广泛报道。因此,这项研究的主要目的是在社区居住的患有慢性疼痛的成年人中确定阿片类药物使用和热痛(HP)感觉之间的关系。这项研究队列涉及187名患有慢性疼痛的成年人(85名阿片类药物和102名非阿片类药物),他们连续接受了门诊跨学科疼痛治疗计划。使用经验证的定量感觉测试方法评估热痛感。阿片类药物使用对HP5-0.5的非标准化(P5 0.004)和标准化(P5 0.005)值有影响,其中阿片组的HP5-0.5值低于非阿片组(更具痛觉过敏)。HP 5-0.5是连接HP 0.5(HP阈值)和HP 5(HP耐受性的中间测量)的线的斜率的量度。在单变量(P5 0.019)和多变量(P5 0.003)线性回归分析中(调整了年龄、性别、体重指数、工作状态、疼痛诊断、疼痛严重程度、抑郁和疼痛灾变),阿片类药物的使用与较低(更具痛觉过敏)的HP5-0.5非标准化值相关。同样,在单变量(P5 0.004)和多变量(P5 0.011)线性回归分析中(根据工作状态、疼痛诊断、疼痛严重程度、抑郁和疼痛灾变进行调整),阿片类药物的使用与较低的HP5-0.5标准值相关。在这个社区居住的成年人样本中,这些观察表明,长期使用阿片类药物与痛觉过敏有关,独立于其他已知的影响幽门螺杆菌知觉的临床因素。
The hyperalgesic effects of long-term opioid use in community-dwelling adults with chronic pain have not been widely reported. Therefore, the primary aim of this study was to determine the associations between opioid use and heat pain (HP) perception in a sample of community-dwelling adults with chronic pain. The study cohort involved 187 adults (85 opioid and 102 nonopioid) with chronic pain consecutively admitted to an outpatient interdisciplinary pain treatment program. Heat pain perception was assessed using a validated quantitative sensory test method of levels. An effect of opioid use was observed for nonstandardized (P 5 0.004) and standardized (P 5 0.005) values of HP 5-0.5 in which values of the opioid group were lower (more hyperalgesic) compared with those of the nonopioid group. HP 5-0.5 is a measure of the slope of the line connecting HP 0.5 (HP threshold) and HP 5 (intermediate measure of HP tolerance). In univariable (P 5 0.019) and multiple variable (P 5 0.003) linear regression analyses (adjusted for age, sex, body mass index, work status, pain diagnosis, pain severity, depression, and pain catastrophizing), opioid use was associated with lower (more hyperalgesic) nonstandardized values of HP 5-0.5. Similarly, in univariable (P 5 0.004) and multiple variable (P 5 0.011) linear regression analyses (adjusted for work status, pain diagnosis, pain severity, depression, and pain catastrophizing), opioid use was associated with lower standardized values of HP 5-0.5. In this sample of community-dwelling adults, these observations suggest that long-term opioid use was associated with hyperalgesia independent of other clinical factors known to influence HP perception.
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