在选择性神经根阻塞后,对疼痛和灾难化之间的关联进行前性研究
Pedram Tabatabaei Shafiei1, Josefin Åkerstedt2, Amar Awad1
1Department of Clinical Science, Umeå University, Umeå, Sweden.
概括
选择性神经根阻塞 (SNRB) 减少腰部根部疼痛 (LRP) 患者的灾难性疼痛. 虽然基线疼痛灾难化并不能预测SNRB的结果,但它可以改善术后,突出其作为结果衡量的作用.
科学领域:
- 疼痛管理 疼痛管理
- 干预性治疗疼痛的药物.
- 疼痛的心理方面.
背景情况:
- 疼痛涉及感官和情感组成部分,受到疼痛灾难性的显著影响.
- 痛苦的灾难化放大了疼痛感知,并培养了无助和反省的感觉.
- 这项研究调查了疼痛灾难化和选择性神经根阻塞 (SNRB) 后在腰部根部疼痛 (LRP) 中的结果之间的联系.
研究的目的:
- 探索LRP患者SNRB后疼痛灾难化和治疗结果之间的关系.
- 为了确定基线疼痛灾难化是否预测对SNRB的反应.
- 评估SNRB对随着时间的推移造成灾难性的疼痛水平的影响.
主要方法:
- 一项前性队列研究包括103名通过MRI确认的LRP患者,他们接受了SNRB.
- 患者报告结果测量信息系统 (PROMIS) -29和疼痛灾难化量表 (PCS) 用于在基线和干预后84天的结果测量.
- 患者被分为响应者 (≥30%的疼痛减轻) 或不响应者,并根据基线PCS得分进行分层. 分析了结果和PCS的变化.
主要成果:
- 基线疼痛灾难化并不是对SNRB疼痛反应的显著预测因素.
- 响应SNRB的患者在干预后显著减少了灾难性的疼痛.
- 这些发现表明SNRB可能会积极影响与疼痛相关的认知应对策略.
结论:
- 在LRP患者中,SNRB有效地减少了灾难性的疼痛.
- 虽然基线疼痛灾难化并不能预测治疗反应,但SNRB后疼痛的减少值得注意.
- 疼痛灾难化是一个重要的考虑因素,作为结果衡量措施,可能比治疗成功的预测指标更有价值.
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