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Conditioned open-label placebo for opioid reduction after spine surgery: a randomized controlled trial
Kelsey M Flowers1, Megan E Patton1, Valerie J Hruschak1
1Departments of Anesthesiology, Perioperative, and Pain Medicine and.
Pain
|January 15, 2021
Summary
Open-label placebos combined with conditioning (COLP) significantly reduced daily opioid use by 30% in spine surgery patients. This innovative approach also lowered worst pain scores, offering a potential new strategy for postoperative pain management.
Area of Science:
- Pain Management
- Clinical Psychology
- Surgical Recovery
Background:
- Traditionally, placebo effects relied on deception.
- Open-label placebos (OLPs) demonstrate efficacy without concealment.
- Conditioning principles can enhance placebo responses.
Purpose of the Study:
- To investigate the efficacy of combining conditioning with open-label placebos (COLP) for postoperative pain and opioid reduction.
- To assess COLP's impact on daily opioid consumption and pain levels in spine surgery patients.
Main Methods:
- A randomized controlled trial comparing COLP to treatment as usual.
- Patients received unrestricted opioid analgesics.
- Generalized estimating equations analyzed daily opioid use and pain from POD 1 to 17.
Main Results:
- COLP group used 30% less daily opioid medication (14.5 MME less).
- COLP group reported lower daily worst pain scores (-1.0 point).
- No significant difference in average daily pain between groups.
Conclusions:
- COLP shows potential as an adjuvant therapy to reduce postoperative opioid consumption.
- COLP may decrease pain intensity without compromising pain relief.
- This method offers a non-deceptive approach to enhance pain management post-surgery.
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