妇科癌症患者入睡潜伏期、主观疼痛与热痛敏感性的相关性研究。
Associations Among Sleep Latency, Subjective Pain, and Thermal Pain Sensitivity in Gynecologic Cancer.
机构信息
Department of Clinical & Health Psychology, University of Florida, Gainesville, Florida.
Department of Psychiatry, University of Missouri, Columbia, Missouri.
出版信息
Pain Med. 2020 Jan 1;21(1):5-12. doi: 10.1093/pm/pny236.
OBJECTIVE
Pain is common among women with gynecologic cancer and contributes to depressed mood, sleep disturbances, and likelihood of future chronic pain. Little is known about how psychosocial factors are associated with central sensitization of pain in gynecologic cancer. This study examined relations among depressive symptoms, sleep, subjective pain, and aftersensation pain (a proxy for central sensitization of pain) in gynecologic cancer.
METHODS
Participants were 42 women (mean age [SD] = 59.60 [10.11] years) enrolled in a randomized clinical trial examining psychological intervention effects on sleep, pain, mood, and stress hormones/cytokines in gynecologic cancer. Six to eight weeks after surgery, participants completed an assessment of depressive symptoms, sleep, and subjective pain and a temporal summation of pain protocol via quantitative sensory testing (QST).
RESULTS
Controlling for recent chemotherapy, history of chronic pain, and analgesic medication use, regression analyses revealed that longer sleep onset latency (SOL; B = 3.112, P = 0.039, bias-corrected and accelerated (BCa) 95% confidence interval [CI] = 0.371 to 6.014) and greater sensory pain (B = 0.695, P = 0.023, BCa 95% CI = 0.085 to 1.210) were associated with greater aftersensation pain at 15 seconds. Greater sensory pain scores were associated with greater aftersensation pain at 30 seconds (B = 0.286, P = 0.045, BCa 95% CI = 0.008 to 0.513). Depression was not associated with aftersensation pain. The overall models accounted for 44.5% and 40.4% of the variance in aftersensation pain at 15 and 30 seconds, respectively. Conclusions. Longer SOL and higher subjective sensory pain were related to greater aftersensation of experimentally induced pain in women postsurgery for gynecologic cancers. Interventions that improve sleep and subjective sensory pain during the perisurgical period may reduce risk for central sensitization of pain.
目的
妇科癌症患者常伴有疼痛，并导致情绪低落、睡眠障碍和未来慢性疼痛的可能性增加。目前对于心理社会因素如何与妇科癌症患者的疼痛中枢敏化相关知之甚少。本研究探讨了妇科癌症患者中抑郁症状、睡眠、主观疼痛和后感觉疼痛（疼痛中枢敏化的代理）之间的关系。
方法
参与者为 42 名女性（平均年龄[标准差]为 59.60[10.11]岁），参加了一项随机临床试验，该试验研究了心理干预对妇科癌症患者睡眠、疼痛、情绪和应激激素/细胞因子的影响。手术后 6-8 周，参与者通过定量感觉测试（QST）完成了抑郁症状、睡眠和主观疼痛以及疼痛时间总和的评估。
结果
在控制近期化疗、慢性疼痛史和镇痛药使用的情况下，回归分析显示，更长的睡眠潜伏期（SOL；B=3.112，P=0.039，偏置校正和加速（BCa）95%置信区间[CI]为 0.371 至 6.014）和更大的感觉疼痛（B=0.695，P=0.023，BCa 95%CI 为 0.085 至 1.210）与 15 秒时更大的后感觉疼痛相关。更大的感觉疼痛评分与 30 秒时更大的后感觉疼痛相关（B=0.286，P=0.045，BCa 95%CI 为 0.008 至 0.513）。抑郁与后感觉疼痛无关。总体模型分别解释了 15 秒和 30 秒后感觉疼痛的 44.5%和 40.4%的方差。结论：SOL 延长和主观感觉疼痛增加与妇科癌症患者手术后实验性诱发疼痛的后感觉增加有关。在围手术期改善睡眠和主观感觉疼痛的干预措施可能会降低疼痛中枢敏化的风险。
Zotero 插件