Smertesensitivitet hos patienter med kroniske lænderygsmerter i opioid behandling:Vurderet ved kvantitative sensoriske test med cuff algometri
Forfattere
Larsen, Isabelle Myriam ; Laustsen, Mette Mebus
Semester
4. semester
Udgivelsesår
2016
Afleveret
2016-05-17
Antal sider
29
Abstract
Kroniske lænderygsmerter (cLBP) er forbundet med ændret smertesensitivitet målt med kvantitative sensoriske test (QST). Opioider bruges i stigende grad til behandling, men langvarig brug kan have alvorlige bivirkninger, herunder opioidinduceret hyperalgesi (OIH), hvor smertefølsomheden kan stige. Dette studie undersøgte, om opioidbehandling hos cLBP-patienter er forbundet med ændringer i smertesensitivitet. Vi gennemførte et køns- og aldersmatchet case-control studie og målte smertetærskel (cPPT), smertetolerance (cPTT) og temporal summation af smerte (TSP; at smerte tiltager ved gentagne stimuli) med cuff-algometri, en manchet der gradvist øger trykket. Tre grupper deltog: 27 cLBP-patienter i opioidbehandling, 27 cLBP-patienter uden opioider og 27 raske kontroller. Patienterne udfyldte også spørgeskemaer om demografi, kliniske smerteforhold og psykologiske variabler. Resultaterne viste, at cLBP-patienter i opioidbehandling havde signifikant lavere smertetolerance (cPTT) end raske kontroller. Begge patientgrupper havde højere smertescore ved tolerancetærskel (VAS ved cPTT) og mere udtalt TSP end raske kontroller. Der var ingen forskel i smertetærskel (cPPT) mellem patientgrupperne og de raske, og de to patientgrupper adskilte sig ikke i de eksperimentelle målinger, kliniske smertekarakteristika eller psykologiske faktorer. Samlet fandt vi ingen forskel i overordnet eksperimentel smertesensitivitet mellem cLBP-patienter i opioidbehandling og dem uden opioider, men begge patientgrupper viste faciliteret TSP sammenlignet med raske.
Chronic low back pain (cLBP) is associated with altered pain sensitivity measured by quantitative sensory testing (QST). Opioids are increasingly used for cLBP, but long-term use can cause serious side effects, including opioid-induced hyperalgesia (OIH), where pain sensitivity may increase. This study examined whether opioid treatment in cLBP patients is linked to changes in pain sensitivity. We conducted a sex- and age-matched case-control study and measured pressure pain threshold (cPPT), pressure pain tolerance (cPTT), and temporal summation of pain (TSP; pain that builds up with repeated stimuli) using cuff algometry, a pressure cuff that gradually increases pressure. Three groups participated: 27 cLBP patients on opioids, 27 cLBP patients not using opioids, and 27 healthy controls. Patients also completed questionnaires on demographics, clinical pain characteristics, and psychological variables. Results showed that cLBP patients receiving opioids had significantly lower pain tolerance (cPTT) than healthy controls. Both patient groups had higher pain ratings at tolerance (VAS at cPTT) and more pronounced TSP than healthy controls. There was no difference in pain threshold (cPPT) between patient groups and healthy controls, and the two patient groups did not differ in experimental measures, clinical pain features, or psychological factors. Overall, we found no difference in experimental pain sensitivity between opioid-treated and non-opioid cLBP patients, while both patient groups showed facilitated TSP compared with healthy controls.
[Dette resumé er genereret ved hjælp af AI]