Amir Renana, Leiba Ronit, Eisenberg Elon
Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
Department of Statistics, Rambam Health Care Campus, Haifa, Israel.
Pain Pract. 2019 Mar;19(3):283-288. doi: 10.1111/papr.12738. Epub 2018 Nov 20.
Despite enormous differences between acute and chronic pain, the numeric pain scale (NRS) is commonly used in pain research and clinical practice for assessing the intensity of both acute and chronic pain. The use of this scale has been challenged as it may fail to accurately reflect the pure intensity of chronic pain.
To compare the effect of anchoring the NRS on the intensity of pain reported by patients with acute vs. chronic pain.
Patients with acute postoperative or chronic pain (n = 100/group) were requested to rate their: current clinical pain intensity on an NRS from 0 to 100; the intensity of an anchoring pain event on the same scale; and subsequently to rate again their current pain intensity while making reference to the reported intensity of the pain event. The magnitude of correction was compared between the 2 groups.
The anchoring pain was rated identically between the groups. However, following anchoring, patients with chronic pain made a significantly larger correction of their pain intensity than did those with acute pain (mean ± standard deviation = 9 ± 9, median [interquartile range] = 10 [0 to 10] vs. 3 ± 7, 0 [0 to 5], respectively; P < 0.0001). More patients in the chronic pain group corrected their pain intensity. Logistic regression showed that chronic pain and female gender significantly increased the likelihood of making the correction (chronic pain: odds ratio 7.2, 95% confidence interval 3.5 to 15.1, P < 0.0001; female gender: odds ratio 2.8, 95% confidence interval 1.4 to 5.5, P < 0.0001).
The results suggest that anchoring the NRS can potentially improve the accuracy of reported chronic pain intensity.
尽管急性疼痛和慢性疼痛存在巨大差异，但数字疼痛量表（NRS）在疼痛研究和临床实践中常用于评估急性和慢性疼痛的强度。该量表的使用受到了质疑，因为它可能无法准确反映慢性疼痛的纯粹强度。
比较锚定NRS对急性疼痛患者与慢性疼痛患者报告的疼痛强度的影响。
要求急性术后疼痛或慢性疼痛患者（每组100例）对以下内容进行评分：使用0至100的NRS对当前临床疼痛强度进行评分；对同一量表上的锚定疼痛事件的强度进行评分；随后在参考所报告的疼痛事件强度的同时，再次对他们当前的疼痛强度进行评分。比较两组之间的校正幅度。
两组对锚定疼痛的评分相同。然而，在进行锚定后，慢性疼痛患者对其疼痛强度的校正幅度明显大于急性疼痛患者（均值±标准差分别为9±9、中位数[四分位间距]=10[0至10]与3±7、0[0至5]；P<0.0001）。慢性疼痛组中更多患者校正了他们的疼痛强度。逻辑回归显示，慢性疼痛和女性性别显著增加了进行校正的可能性（慢性疼痛：比值比7.2，95%置信区间3.5至15.1，P<0.0001；女性性别：比值比2.8，95%置信区间1.4至5.5，P<0.0001）。
结果表明，锚定NRS可能会提高所报告的慢性疼痛强度的准确性。
