在年长的成年人中,在催眠下处方后感知到的疼痛
Jennifer G Hurtado1,2, Alexander J Erickson2,3, Michael N Mitchell2
1Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada, USA.
Journal of the American Geriatrics Society
|January 10, 2026
概括
与失眠认知行为疗法 (CBTI) 一起处方佐地亚类受体激活剂 (BZRA) 并没有使老年人疼痛恶化. 这种综合方法为管理失眠和并发性疼痛提供了一个安全的选择.
科学领域:
- 老年学是一门学科.
- 睡眠医学 睡眠医学
- 疼痛管理 疼痛管理
背景情况:
- 患有慢性失眠的老年人经常使用二二胺受体激动剂 (BZRA),尽管存在相关风险和可用的非药物替代品,如失眠认知行为疗法 (CBTI).
- CBTI可以减少失眠的严重程度,并可能改善疼痛结果,即使在BZRA抑郁症期间.
- 在BZRA抑郁症期间,害怕疼痛恶化可能会阻止参与,特别是当疼痛与失眠并发时.
研究的目的:
- 为了研究在接受同时接受BZRA抑郁和CBTI的老年人中疼痛结果的变化.
- 评估停止使用BZRA对疼痛严重程度和日常活动干扰的影响.
主要方法:
- 来自一项随机临床试验的二次数据分析,涉及188名老年人 (68%年龄在65岁以上).
- 参与者同时接受CBTI和BZRA减压干预 (缓和).
- 在基线,治疗后1周和6个月,使用简要疼痛库存 (BPI) 评估疼痛,并使用混合效应模型进行分析.
主要成果:
- 随着时间的推移,在一般队列或65岁及以上的患者中,没有观察到整体疼痛严重程度的显著变化.
- 在治疗后1周,人们注意到疼痛干扰日常生活的短期显著减少,但这些并没有达到临床重要差异最小值 (MCID) 值,并且在6个月内没有持续.
- BZRA抑郁症和CBTI的联合干预并没有导致疼痛结果的显著恶化.
结论:
- 结合BZRA抑郁症和CBTI对于患有失眠和并发性疼痛的老年人来说是一个可行的策略,因为它似乎不会加剧疼痛.
- 这些发现表明,这种综合方法可以安全地实施,解决了人们对在停止使用BZRA期间疼痛恶化的担忧.
- 需要进一步的研究来确定专门针对慢性失眠的老年人疼痛管理的干预措施,这些老年人正在接受抑郁症治疗.
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