School of Nursing, University of Sao Paulo, Sao Paulo, Brazil.
Acta Anaesthesiol Scand. 2012 Nov;56(10):1257-66. doi: 10.1111/j.1399-6576.2012.02760.x. Epub 2012 Sep 4.
The paucity of studies regarding cognitive function in patients with chronic pain, and growing evidence regarding the cognitive effects of pain and opioids on cognitive function prompted us to assess cognition via neuropsychological measurement in patients with chronic non-cancer pain treated with opioids.
In this cross-sectional study, 49 patients were assessed by Continuous Reaction Time, Finger Tapping, Digit Span, Trail Making Test-B and Mini-mental State Examination tests. Linear regressions were applied.
Patients scored poorly in the Trail Making Test-B (mean = 107.6 s, SD = 61.0, cut-off = 91 s); and adequately on all other tests. Several associations among independent variables and cognitive tests were observed. In the multiple regression analyses, the variables associated with statistically significant poor cognitive performance were female sex, higher age, lower annual income, lower schooling, anxiety, depression, tiredness, lower opioid dose, and more than 5 h of sleep the night before assessment (P < 0.05).
Patients with chronic pain may have cognitive dysfunction related to some reversible factors, which can be optimized by therapeutic interventions.
慢性疼痛患者的认知功能研究较少，而越来越多的证据表明疼痛和阿片类药物对认知功能的影响促使我们通过神经心理学测量评估接受阿片类药物治疗的慢性非癌痛患者的认知功能。
在这项横断面研究中，对 49 名患者进行了连续反应时间、手指敲击、数字跨度、连线测试 B 和简易精神状态检查测试。应用线性回归。
患者在连线测试 B 中得分较低（平均值=107.6 秒，标准差=61.0，临界值=91 秒）；而在其他所有测试中得分都还可以。观察到一些独立变量和认知测试之间的关联。在多元回归分析中，与认知表现显著较差相关的变量为女性、年龄较大、年收入较低、受教育程度较低、焦虑、抑郁、疲劳、阿片类药物剂量较低，以及评估前一晚睡眠时间超过 5 小时（P<0.05）。
慢性疼痛患者可能存在与某些可逆转因素相关的认知功能障碍，通过治疗干预可以优化这些因素。
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