Deshpande Maneesh A, Holden Ronald R, Gilron Ian
Department of Anesthesiology, Queen's University, Kingston General Hospital, Kingston, Ontario, Canada.
Anesth Analg. 2006 May;102(5):1473-9. doi: 10.1213/01.ane.0000204295.90178.77.
Mood and quality of life (QOL) outcomes vary widely in neuropathic pain trials. This may be a result of variable analgesia and other treatment effects. We evaluated the relationship between pain reduction and mood/QOL in neuropathic pain. Pain, side effects, QOL, and mood from a trial of morphine, gabapentin, and a morphine-gabapentin combination were examined. Baseline QOL was impaired according to Short Form Health Survey (SF-36) scores. Baseline mood, according to Profile of Mood States scores, was comparable to that of a nondepressed population. Pain reduction with all three active trial treatments correlated with improved QOL. Pain reduction with morphine and with gabapentin correlated with improved mood. Pain reduction with a morphine-gabapentin combination correlated with improvement in only one of several domains of the Profile of Mood States. Severity of sedation, constipation, and dry mouth during any treatment did not correlate with mood/QOL changes. These results can be interpreted to imply that larger analgesic treatment effect sizes lead to more substantial improvements in QOL and/or mood. However, other beneficial or adverse treatment-related side effects may also affect mood/QOL. Therefore, future studies are needed to also evaluate the impact of treatment-related side effects on mood/QOL in analgesic trials.
在神经性疼痛试验中，情绪和生活质量（QOL）结果差异很大。这可能是镇痛效果及其他治疗效果存在差异的结果。我们评估了神经性疼痛中疼痛减轻与情绪/QOL之间的关系。对一项关于吗啡、加巴喷丁以及吗啡 - 加巴喷丁组合的试验中的疼痛、副作用、QOL和情绪进行了检查。根据简短健康调查（SF - 36）评分，基线QOL受损。根据情绪状态剖面图评分，基线情绪与非抑郁人群相当。所有三种活性试验治疗的疼痛减轻均与QOL改善相关。吗啡和加巴喷丁治疗导致的疼痛减轻与情绪改善相关。吗啡 - 加巴喷丁组合治疗导致的疼痛减轻仅与情绪状态剖面图几个领域中的一个领域的改善相关。任何治疗期间镇静、便秘和口干的严重程度与情绪/QOL变化均无相关性。这些结果可以解释为意味着更大的镇痛治疗效应大小会导致QOL和/或情绪有更显著的改善。然而，其他有益或有害的治疗相关副作用也可能影响情绪/QOL。因此，未来的研究还需要评估镇痛试验中治疗相关副作用对情绪/QOL的影响。
