Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, Massachusetts, USA.
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Pain Med. 2022 Aug 31;23(9):1570-1581. doi: 10.1093/pm/pnac025.
Respiratory-gated Auricular Vagal Afferent Nerve stimulation (RAVANS) is a safe nonpharmacological approach to managing chronic pain. The purpose of the current study was to examine (1) the feasibility and acceptability of RAVANS, combined with mindful meditation (MM) for chronic low back pain (CLBP), (2) the potential synergy of MM+RAVANS on improving pain, and (3) possible moderators of the influence of MM+RAVANS on pain.
Pilot feasibility and acceptability study.
Pain management center at large academic medical center.
Nineteen adults with CLBP and previous MM training.
Participants attended two sessions during which they completed quantitative sensory testing (QST), rated pain severity, and completed a MM+stimulation session. Participants received RAVANS during one visit and sham stimulation during the other, randomized in order. Following intervention, participants repeated QST.
MM+RAVANS was well tolerated, acceptable, and feasible to provide relief for CLBP. Both MM+stimulation sessions resulted in improved back pain severity, punctate pain ratings, and pressure pain threshold. Individuals with greater negative affect showed greater back pain improvement from MM+RAVANS while those with greater mindfulness showed greater back pain improvement from MM+sham.
Results suggest that for CLBP patients with prior MM training, the analgesic effects of MM may have overshadowed effects of RAVANS given the brief single session MM+RAVANS intervention. However, those with greater negative affect may benefit from combined MM+RAVANS.
呼吸门控耳迷走神经刺激（RAVANS）是一种安全的非药物方法，可用于治疗慢性疼痛。本研究的目的是检验：（1）RAVANS 结合正念冥想（MM）治疗慢性下腰痛（CLBP）的可行性和可接受性；（2）MM+RAVANS 改善疼痛的潜在协同作用；（3）MM+RAVANS 对疼痛影响的可能调节因素。
试点可行性和可接受性研究。
大型学术医疗中心的疼痛管理中心。
19 名患有 CLBP 且有既往 MM 训练的成年人。
参与者参加了两次会议，期间他们完成了定量感觉测试（QST），评定疼痛严重程度，并完成了 MM+刺激会议。参与者在一次就诊中接受 RAVANS 治疗，在另一次就诊中接受假刺激，随机顺序。干预后，参与者重复 QST。
MM+RAVANS 耐受性良好，可接受，并且可以缓解 CLBP。两次 MM+刺激会议均导致腰痛严重程度、点状疼痛评分和压力疼痛阈值改善。负性情绪较高的个体从 MM+RAVANS 中获得更大的腰痛改善，而正念程度较高的个体从 MM+假刺激中获得更大的腰痛改善。
结果表明，对于有既往 MM 训练的 CLBP 患者，鉴于单次 MM+RAVANS 干预时间较短，MM 的镇痛作用可能掩盖了 RAVANS 的作用。然而，那些负性情绪较高的人可能会从 MM+RAVANS 中受益。
