Nocebo-Induced Hyperalgesia During Local Anesthetic Injection
Nocebo-Induced Hyperalgesia During Local Anesthetic Injection
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DOI：
10.1213/ane.0b013e3181cc5727
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发表时间：
2010-03-01
影响因子：
5.7
通讯作者：
Camann, William R.
中科院分区：
文献类型：
--
作者：
Varelmann, Dirk;Pancaro, Carlo;Camann, William R.
局部麻醉注射过程中的常见做法是用诸如“你会感到很大的蜜蜂蜇伤；这是最糟糕的部分”之类的话警告患者。我们的假设是，使用更温和的语言进行局部麻醉可以改善疼痛感知和患者舒适度。一百四十名要求椎管内镇痛的足月妊娠健康女性被随机分配到“安慰剂”组（“我们将给您一种局部麻醉剂，使该区域麻木，您在手术过程中会感到舒适”）或“反安慰剂”组（“您会感到很大的蜜蜂蜇伤；这是手术中最糟糕的部分”）组。局部麻醉皮肤注射后立即使用 0 至 10 分的言语模拟量表评分来评估疼痛。与使用更严厉的反安慰剂词汇相比，使用令人安心的词语时言语模拟量表疼痛评分中位数较低（3 [2-4] vs 5 [3-6]；P < 0.001）。我们的数据表明，使用更温和、更令人放心的词语可以改善侵入性手术期间的主观体验。 （麻醉分析 2010；110：868-70）
Common practice during local anesthetic injection is to warn the patient using words such as: "You will feel a big bee sting; this is the worst part." Our hypothesis was that using gentler words for administration of the local anesthetic improves pain perception and patient comfort. One hundred forty healthy women at term gestation requesting neuraxial analgesia were randomized to either a "placebo" ("We are going to give you a local anesthetic that will numb the area and you will be comfortable during the procedure") or "nocebo" ("You are going to feel a big bee sting; this is the worst part of the procedure") group. Pain was assessed immediately after the local anesthetic skin injection using verbal analog scale scores of 0 to 10. Median verbal analog scale pain scores were lower when reassuring words were used compared with the harsher nocebo words (3 [2-4] vs 5 [3-6]; P < 0.001). Our data suggest that using gentler, more reassuring words improves the subjective experience during invasive procedures. (Anesth Analg 2010;110:868-70)