PAIN CONTROL METHODS-- EFFECTS OF MORPHINE, DISTRACTION, & MOOD CHANGES ON PAIN

疼痛控制方法——吗啡的作用、分散注意力、

• 批准号: 6309237
• 负责人: CHARLES S CLEELAND
• 金额: $ 1.11万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-12-01 至 2001-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6309237
• 关键词: aggression; behavior modification; behavioral /social science research tag; clinical research; clinical trials; combination therapy; diphenylhydramine; drug screening /evaluation; emotional adjustment; human subject; human therapy evaluation; mechanical pressure; morphine; pain; pain threshold; placebos; psychotherapy; stress management

This represents a series of two laboratory studies examining several components of behavioral pain control: mood alteration and distraction. A critical feature is the examination of these behavioral components in the presence of morphine, the prototypic drug for aggressive pharmacologic pain management. It is recognized that behavioral control of pain, if used at all, will often be used in conjunction with analgesics. The specific aims of the study are (a) to examine the combined effects of morphine and mental distraction on pain tolerance and pain ratings of intensity and unpleasantness in normal subjects, and (b) to examine the combined effects of morphine and positive mood induction on pain tolerance and pain ratings of intensity and unpleasantness in normal subjects. The pain stimulus will be pressure to the index finger produced by a pressure algometer. Subjects in Study A are randomly assigned to 1 of 5 conditions: morphine with distraction, morphine alone, active placebo with distraction, active placebo alone, and inactive placebo. This study has commenced in the University Clinical Research Center (CRC) at Hermann Hospital. During the second year of the award, we initiated this study in the University Clinical Research Center (CRC) at Hermann Hospital. The hypothesis for Study A is that the combined use of distraction and morphine will have the greatest effect on pain perception, followed in order by: morphine alone, distraction with an active placebo (diphenhydramine), an active placebo, and an inactive placebo. Eight subjects (three females, five males) were enrolled in the pilot phase of the study. Some minor adjustments in the study procedures were necessary. The tonic pain stimulus is pressure stimulation from the pressure algometer. We initially used 1.0 kg of weight on the algometer but subsequently increased the weight to 2.0 kg. This increase was indicated as the subjects' baseline pain tolerance was greater than the 5-minute limit for the pressure stimulus. We also adjusted the timing of the baseline blood draw in order to avoid influencing the subjects baseline pain tolerance. In addition, minor changes were made in the instructions for the distraction task in order to make the task requirements easier to comprehend. Subjects in Study B will be assigned to 1 of 7 conditions: morphine with positive mood, morphine with neutral mood, morphine alone, active placebo with positive mood, active placebo with neutral mood, active placebo alone, and inactive placebo. The primary outcome variable will be change in pain tolerance time. Secondary outcome measures will be changes in pain intensity and unpleasantness ratings.

这代表了一系列的两个实验室研究，检查行为疼痛控制的几个组成部分：情绪改变和分心。一个关键的特征是在吗啡的存在下检查这些行为成分，吗啡是积极的药理学疼痛管理的原型药物。 人们认识到，疼痛的行为控制，如果使用的话，通常会与镇痛药一起使用。本研究的具体目的是（a）检查吗啡和精神分散对正常受试者疼痛耐受性和疼痛强度及不愉快等级的综合影响，以及（B）检查吗啡和积极情绪诱导对正常受试者疼痛耐受性和疼痛强度及不愉快等级的综合影响。 疼痛刺激将是由压力痛觉计产生的对食指的压力。研究A中的受试者被随机分配到5种条件中的一种：吗啡与分心、单独吗啡、活性安慰剂与分心、单独活性安慰剂和非活性安慰剂。 本研究已在赫尔曼医院的大学临床研究中心（CRC）开始。 在获奖的第二年，我们在赫尔曼医院的大学临床研究中心（CRC）启动了这项研究。研究A的假设是，分心和吗啡的联合使用对疼痛感知的影响最大，其次是：单独使用吗啡，分心与活性安慰剂（苯海拉明），活性安慰剂和非活性安慰剂。 8例受试者（3例女性，5例男性）入组研究的初步阶段。 研究程序中的一些微小调整是必要的。 强直性疼痛刺激是来自压力痛觉计的压力刺激。 我们最初在痛觉计上使用1.0 kg的重量，但随后将重量增加到2.0 kg。 这种增加是指受试者的基线疼痛耐受性大于压力刺激的5分钟限制。我们还调整了基线抽血的时间，以避免影响受试者的基线疼痛耐受性。 此外，对分心任务的说明进行了微小更改，以使任务要求更容易理解。研究B中的受试者将被分配至7种条件之一：吗啡伴积极情绪、吗啡伴中性情绪、吗啡单药、活性安慰剂伴积极情绪、活性安慰剂伴中性情绪、活性安慰剂单药和非活性安慰剂。 主要结局变量将是疼痛耐受时间的变化。 次要结局指标将是疼痛强度和不愉快评分的变化。