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急性疼痛临床试验的当前方法与挑战

Current methods and challenges for acute pain clinical trials.

作者信息

Gilron Ian, Carr Daniel B, Desjardins Paul J, Kehlet Henrik

机构信息

Departments of Anesthesiology and Perioperative Medicine and.

Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada.

出版信息

Pain Rep. 2018 Apr 2;4(3):e647. doi: 10.1097/PR9.0000000000000647. eCollection 2019 May-Jun.

Abstract

INTRODUCTION

The clinical setting of acute pain has provided some of the first approaches for the development of analgesic clinical trial methods.

OBJECTIVES

This article reviews current methods and challenges and provides recommendations for future design and conduct of clinical trials of interventions to treat acute pain.

CONCLUSION

Growing knowledge about important diverse patient factors as well as varying pain responses to different acute pain conditions and surgical procedures has highlighted several emerging needs for acute pain trials. These include development of early-phase trial designs that minimize variability and thereby enhance assay sensitivity, minimization of bias through blinding and randomization to treatment allocation, and measurement of clinically relevant outcomes such as movement-evoked pain. However, further improvements are needed, in particular for the development of trial methods that focus on treating complex patients at high risk of severe acute pain.

摘要

引言

急性疼痛的临床环境为镇痛临床试验方法的发展提供了一些最初的途径。

目的

本文回顾了当前的方法和挑战,并为未来治疗急性疼痛干预措施的临床试验设计和实施提供建议。

结论

对重要的不同患者因素以及对不同急性疼痛状况和手术程序的不同疼痛反应的认识不断增加,凸显了急性疼痛试验的几个新出现的需求。这些需求包括开发早期试验设计,以尽量减少变异性,从而提高测定灵敏度;通过盲法和随机分配治疗来尽量减少偏倚;以及测量临床相关结局,如运动诱发疼痛。然而,还需要进一步改进,特别是在开发专注于治疗有严重急性疼痛高风险的复杂患者的试验方法方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f5/6749920/e1eb16a31904/painreports-4-e647-g005.jpg

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