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

疼痛控制方法——吗啡的作用、分散注意力、

基本信息

批准号：
6265673
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
项目类别：
财政年份：
1998
资助国家：
美国
起止时间：
1998-12-01 至 1999-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/6265673
关键词：
aggression behavior modification behavioral /social science research tag clinical research combination therapy diphenylhydramine emotional adjustment human subject human therapy evaluation mechanical pressure morphine pain pain threshold placebos psychotherapy stress management

项目摘要

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.

这代表了一系列两项实验室研究，检查行为疼痛控制的几个组成部分：情绪改变和分心。一个关键特征是在吗啡存在的情况下检查这些行为成分，吗啡是积极的药物疼痛管理的原型药物。人们认识到，如果确实使用疼痛的行为控制，通常会与镇痛药结合使用。该研究的具体目的是（a）检查吗啡和精神分散对正常受试者的疼痛耐受性以及疼痛强度和不愉快程度的评级的综合影响，以及（b）检查吗啡和积极情绪诱导对疼痛耐受性和疼痛强度和不愉快程度的综合影响。正常受试者的疼痛耐受性以及疼痛强度和不愉快程度的评级。疼痛刺激是压力计对食指产生的压力。研究 A 中的受试者被随机分配到 5 种情况中的一种：吗啡分散注意力、单独吗啡、活性安慰剂分散注意力、单独活性安慰剂和非活性安慰剂。这项研究已在赫尔曼医院大学临床研究中心 (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，分散注意力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、用活性安慰剂（苯海拉明）分散注意力、活性安慰剂和非活性安慰剂。八名受试者（三名女性，五名男性）被纳入该研究的试点阶段。研究程序的一些细微调整是必要的。强直性疼痛刺激是来自压力痛觉计的压力刺激。我们最初在海藻计上使用 1.0 公斤的重量，但随后将重量增加到 2.0 公斤。这种增加表明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，对分散注意力任务的说明进行了细微的修改，以使任务要求更容易理解。研究 B 中的受试者将被分配到 7 种情况中的一种：吗啡伴有积极情绪、吗啡伴有中性情绪、单独使用吗啡、积极安慰剂具有积极情绪、积极安慰剂具有中性情绪、单独服用活性安慰剂和无效安慰剂。主要结果变量是疼痛耐受时间的变化。次要结果指标是疼痛强度和不愉快程度的变化。