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右美托咪定用于伴有焦虑和抑郁的慢性疼痛患者:一项倾向评分匹配队列研究。

Dexmedetomidine for chronic pain patients with anxiety and depression: a propensity score matching cohort study.

作者信息

Ren Yiting, Huang Peng, Jin Xiaohong

机构信息

Department of Anesthesiology and Pain, The First Affiliated Hospital of Soochow University, Pinghai Road NO. 899, Suzhou City, Jiangsu Province, China.

出版信息

BMC Anesthesiol. 2025 Apr 29;25(1):222. doi: 10.1186/s12871-025-03087-x.

Abstract

BACKGROUND

Chronic pain patients often experience moderate to severe anxiety and depressive symptoms. Growing evidence supporting dexmedetomidine as a potential treatment for mental health conditions, research on its application in chronic pain patients with comorbid anxiety and depression remains limited.

METHODS

Patients who received intravenous infusions of dexmedetomidine during their interventional pain management procedures from January to July 2024 were compared to those who underwent similar procedures without dexmedetomidine infusion during the same period, utilizing propensity score matching.

RESULTS

A total of 290 patients were included in the analysis from January to July 2024. Propensity score matching resulted in 92 matched pairs for further analysis. At the one-month follow-up, the perioperative application of dexmedetomidine was associated with a greater improvement in anxiety and depression disorders, as measured by the Generalized Anxiety Disorder 7-item scale, showing a reduction of -4.43 points (95% CI, -4.98 to -3.88) compared to -2.42 points (95% CI, -2.97 to -1.87) for the local analgesia group and the Patient Health Questionnaire-9 scores indicated a reduction of -6.19 points (95% CI, -6.84 to -5.55) for the dexmedetomidine group versus -3.92 points (95% CI, -4.56 to -3.28) for the local analgesia group. The use of dexmedetomidine was also associated with a greater improvement of pain(-3.32 points vsurs -2.62 points).

CONCLUSIONS

Intraoperative dexmedetomidine significantly improves anxiety and depression in patients with chronic pain. Therefore, dexmedetomidine may serve as a promising adjunctive treatment for chronic pain patients, particularly those with comorbid anxiety and depression.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

慢性疼痛患者常伴有中度至重度焦虑和抑郁症状。越来越多的证据支持右美托咪定作为一种潜在的心理健康状况治疗方法,但其在合并焦虑和抑郁的慢性疼痛患者中的应用研究仍然有限。

方法

将2024年1月至7月在介入性疼痛管理过程中接受右美托咪定静脉输注的患者与同期接受类似手术但未输注右美托咪定的患者进行比较,采用倾向评分匹配法。

结果

2024年1月至7月共有290例患者纳入分析。倾向评分匹配产生了92对匹配对用于进一步分析。在1个月的随访中,通过广泛性焦虑障碍7项量表测量,围手术期应用右美托咪定与焦虑和抑郁障碍的更大改善相关,与局部镇痛组的-2.42分(95%CI,-2.97至-1.87)相比,降低了-4.43分(95%CI,-4.98至-3.88),患者健康问卷-9评分显示右美托咪定组降低了-6.19分(95%CI,-6.84至-5.55),而局部镇痛组降低了-3.92分(95%CI,-4.56至-3.28)。右美托咪定的使用还与疼痛的更大改善相关(-3.32分对-2.62分)。

结论

术中右美托咪定可显著改善慢性疼痛患者的焦虑和抑郁。因此,右美托咪定可能是慢性疼痛患者,尤其是合并焦虑和抑郁患者的一种有前景的辅助治疗方法。

临床试验编号

不适用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e40c/12039180/749c7084ebd2/12871_2025_3087_Fig1_HTML.jpg

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