Geden E A, Beck N C, Anderson J S, Kennish M E, Mueller-Heinze M
Nurs Res. 1986 Sep-Oct;35(5):301-6.
Using an analogued labor pain procedure, the efficacy of combinations of five cognitive and one pharmacologic approach to pain management was examined. Nulliparous undergraduates (N = 120) were randomly assigned to 1 of 12 groups. Cognitive groups included: systematic desensitization (SYS DENS); sensory description (SEN DESC); sensory transformation (ST); modeling (M); and relaxation (R); combined groups: SYS DENS, SEN DESC, and ST; SEN DESC, ST, and R; SEN DESC, R, ST, and Demerol. Pharmacologic groups included expected Demerol, did not expect Demerol, placebo, and no treatment control. Subjects assigned to a cognitive group received two 1-hour training sessions 1 week apart. Remaining subjects were given the assigned pharmacologic treatment one-half hour prior to the exposure to the painful stimulus. Assessment of the cognitive and pharmacologic approaches were made in a 1-hour session involving twenty 80-second exposures to a laboratory pain stimulus patterned to resemble labor contractions. Dependent variables included self-reported pain, blood pressure, frontalis electromyograph, heart rate, and respiratory rate. Significant treatment by trials and treatment effects were found for self-reported pain. No other effects achieved statistical significance.
采用模拟分娩疼痛程序，研究了五种认知方法与一种药物方法相结合用于疼痛管理的效果。未生育的大学生（N = 120）被随机分配到12组中的一组。认知组包括：系统脱敏（SYS DENS）；感觉描述（SEN DESC）；感觉转换（ST）；示范（M）；以及放松（R）；联合组：SYS DENS、SEN DESC和ST；SEN DESC、ST和R；SEN DESC、R、ST和度冷丁。药物组包括预期使用度冷丁、未预期使用度冷丁、安慰剂和无治疗对照组。分配到认知组的受试者在相隔1周的时间里接受两次1小时的训练课程。其余受试者在暴露于疼痛刺激前半小时接受指定的药物治疗。在一个1小时的时段内对认知和药物方法进行评估，该时段包括20次80秒的实验室疼痛刺激暴露，这些刺激被设计成类似分娩宫缩的模式。因变量包括自我报告的疼痛、血压、额肌肌电图、心率和呼吸频率。在自我报告的疼痛方面发现了显著的试验与治疗交互作用和治疗效果。没有其他效果达到统计学显著性。
