Reinecke H, Sorgatz H
Leitlinienbüro LONTS, Klinische Psychologie und Psychotherapie, Technische Universität Darmstadt, Darmstadt.
Schmerz. 2009 Oct;23(5):440-7. doi: 10.1007/s00482-009-0839-9.
The German Society for the Study of Pain (DGSS) commissioned a meta-analytic review of the evidence on the long-term effects of opioids, non-opioid analgesics and cognitive- behavioral procedures for chronic non-cancer pain. A multidisciplinary expert panel was established to review the evidence and formulate recommendations as far as possible on the basis of means, standard deviations and group sizes from randomized controlled trials. Effect size estimates of analgesic effects (SMDs, WMDs) from studies were below clinical significance, whenever the reported data permitted evaluation and nearly equal for all the investigated medical therapies and pain syndromes. Therefore, the LONTS guidelines focus on the prevention of adverse effects and misuse and a multidisciplinary approach for the treatment of chronic pain is strongly recommended. Principles of opioid prescription and on the management of risks associated with the long-term use of opioids are described.
德国疼痛研究协会（DGSS）委托对阿片类药物、非阿片类镇痛药以及认知行为疗法对慢性非癌性疼痛的长期影响的证据进行荟萃分析综述。成立了一个多学科专家小组来审查证据，并尽可能根据随机对照试验的均值、标准差和样本量制定建议。只要报告的数据允许评估，研究中镇痛效果的效应量估计值（标准化均数差、加权均数差）均低于临床显著性水平，并且对于所有研究的药物疗法和疼痛综合征几乎相等。因此，LONTS指南侧重于不良反应的预防和误用，并强烈推荐采用多学科方法治疗慢性疼痛。文中描述了阿片类药物处方原则以及与长期使用阿片类药物相关的风险的管理。
