Service d'Accueil des Urgences, GH Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, 47-83 Boulevard de l'Hôpital, 75651, Paris, France.
Medical University Clinic, Kantonsspital Aarau, Tellstrasse 25, Haus 7, 5001, Aarau, Switzerland.
Sci Rep. 2022 Mar 19;12(1):4767. doi: 10.1038/s41598-022-08657-4.
The effect of pain and analgesics on stress biomarkers is not well studied. We evaluated the effect of acute pain and analgesics on serum cortisol and copeptin in an experimental pain model in healthy volunteers. Healthy volunteers presented at 8 a.m. for an experimental pain stimulation. Cortisol and copeptin levels were measured before, during and after electrophysiological stimulation, first before and then during opioid delivery. Difference in biomarker levels compared to baseline levels was calculated, and potential influencing factors were evaluated by linear regression analysis. Cortisol decreased by 13% during the 10 min of rest at baseline, but copeptin did not change significantly. Cortisol had a median decrease of -24% or -83 nmol/l (-44 to -124 nmol/l, p = 0.0002) during the electrophysiological stimulation training session, while the median difference for copeptin was -22% or -1.01 pmol/l (-2.35 to 0.08 pmol/l, p = 0.0003). After administration of opioids, cortisol did not decrease but increased by 3% (p = 0.043), indicating an increasing opioids effect on cortisol. This effect was not visible for copeptin (median change -0.003 pmol/l (-0.50 to 0.24), p = 0.45). In this experimental pain model performed in the morning, moderate pain did not have a relevant effect on cortisol or copeptin levels, whereas opioids led to a discrete peak of cortisol.Clinicaltrials.gov identifier: NCT01975753 (registered on November 5, 2013, before start of recruitment).
疼痛和镇痛药对应激生物标志物的影响尚未得到充分研究。我们在健康志愿者的实验性疼痛模型中评估了急性疼痛和镇痛药对血清皮质醇和 copeptin 的影响。健康志愿者于上午 8 点就诊，进行实验性疼痛刺激。在电生理刺激前、刺激期间和刺激后测量皮质醇和 copeptin 水平，首先在阿片类药物给药前，然后在给药期间。通过线性回归分析评估生物标志物水平与基线水平的差异，并评估潜在的影响因素。皮质醇在基线时的 10 分钟休息期间下降了 13%，但 copeptin 没有明显变化。在电生理刺激训练期间，皮质醇的中位数下降了-24%或-83nmol/l（-44 至-124nmol/l，p=0.0002），而 copeptin 的中位数差异为-22%或-1.01pmol/l（-2.35 至 0.08pmol/l，p=0.0003）。给予阿片类药物后，皮质醇没有下降反而增加了 3%（p=0.043），表明阿片类药物对皮质醇的影响增加。这种效应在 copeptin 中并不明显（中位数变化-0.003pmol/l（-0.50 至 0.24），p=0.45）。在上午进行的这个实验性疼痛模型中，中度疼痛对皮质醇或 copeptin 水平没有明显影响，而阿片类药物导致皮质醇出现离散的峰值。临床试验.gov 标识符：NCT01975753（于 2013 年 11 月 5 日注册，在招募开始之前）。
