Panjabi Sumeet S, Panjabi Ravi S, Shepherd Marvin D, Lawson Kenneth A, Johnsrud Michael, Barner Jamie
Elan Pharmaceuticals, Inc., South San Francisco, California, USA.
Pain Med. 2008 Nov;9(8):985-93. doi: 10.1111/j.1526-4637.2008.00483.x. Epub 2008 Aug 7.
To evaluate the impact of an extended-release, once-daily morphine sulfate formulation on depressive symptoms and neurocognition in patients with chronic nonmalignant pain.
Prospective, open-label, one-group trial with a pretest-posttest design.
Outpatient pain management clinic.
Chronic nonmalignant pain patients inadequately controlled with short-acting opioid analgesics and eligible for treatment with once-daily morphine sulfate were initiated on a dose at or near the morphine-equivalent dose of the short-acting regimen.
The following assessments were made at baseline and 4 weeks after initiating intervention: pain intensity, pain unpleasantness, pain suffering, pain behaviors, Beck Depression Inventory, and cognitive function.
Eighty-four patients provided usable data. Pain intensity, unpleasantness, and suffering scores were significantly reduced at follow-up (P = 0.001). The mean Beck Depression Inventory scores were significantly lower at follow-up (P = 0.001). Significant improvements were seen in scores at follow-up on the three validated neurocognitive tests: the digit span test, the digit symbol substitution test, and the paced auditory serial addition test (P = 0.001).
Achieving adequate pain control with once-daily morphine was associated with a reduction in pain and improvements in depressive symptoms and cognitive functioning in the short term.
评估硫酸吗啡缓释片每日一次给药方案对慢性非恶性疼痛患者抑郁症状及神经认知功能的影响。
采用前后测设计的前瞻性、开放标签单组试验。
门诊疼痛管理诊所。
使用短效阿片类镇痛药控制不佳且适合每日一次硫酸吗啡治疗的慢性非恶性疼痛患者，起始剂量为短效治疗方案的吗啡等效剂量或接近该剂量。
在基线期及开始干预4周后进行以下评估：疼痛强度、疼痛不适感、疼痛痛苦感、疼痛行为、贝克抑郁量表及认知功能。
84例患者提供了可用数据。随访时疼痛强度、不适感及痛苦感评分显著降低（P = 0.001）。随访时贝克抑郁量表平均评分显著降低（P = 0.001）。在三项经过验证的神经认知测试（数字广度测试、数字符号替换测试及听觉连续加法测试）中，随访时评分有显著改善（P = 0.001）。
每日一次吗啡实现充分的疼痛控制与短期内疼痛减轻、抑郁症状及认知功能改善相关。
