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条件训练 + 开放标签安慰剂用于青少年特发性脊柱侧弯术后疼痛管理的有效性

Effectiveness of conditioning + open-label placebo for post-operative pain management in adolescent idiopathic scoliosis.

作者信息

Furie Kira S, James Kaitlyn, Kaptchuk Ted J, Diab Mohammad

机构信息

Department of Physical Medicine & Rehabilitation, McGaw Medical Center of Northwestern University, Chicago, IL, USA.

Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California.

出版信息

Pain Manag. 2025 Jul;15(7):363-371. doi: 10.1080/17581869.2025.2520148. Epub 2025 Jun 19.

Abstract

The vast majority of placebos are administered with concealment or deception. Most clinicians and researchers believe that either deception or concealment is necessary to achieve a placebo response; however, recent studies with open-label placebo (OLP), conditioning, and conditioning + OLP (COLP) have shown that placebos can be effective even when patients know they are receiving a placebo. To date, no studies have examined COLP in a pediatric surgical population, which is vulnerable to developing opioid dependence. COLP may assist in lowering opioid doses administered and quicker tapering off opioids. This study investigates the effectiveness of COLP on postoperative treatment of patients ages 10 through 17 undergoing posterior fusion for adolescent idiopathic scoliosis (AIS). It is a randomized controlled trial of 64 AIS patients assigned to one of the two arms: COLP + treatment as usual (TAU) and TAU control. Randomization and baseline assessments occur at the preoperative visit. Opioid consumption is recorded weekly after hospitalization until the first in-person postoperative visit at 6 weeks. The primary outcome measure is postoperative opioid consumption, both amount and duration. Secondary outcomes include pain, functional ability, and mental health scores.

摘要

绝大多数安慰剂是在隐蔽或欺骗的情况下给予的。大多数临床医生和研究人员认为,欺骗或隐蔽对于产生安慰剂反应是必要的;然而,最近关于开放标签安慰剂(OLP)、条件作用以及条件作用+开放标签安慰剂(COLP)的研究表明,即使患者知道自己正在接受安慰剂,安慰剂也可能有效。迄今为止,尚无研究在易患阿片类药物依赖的儿科手术人群中检验COLP。COLP可能有助于降低阿片类药物的给药剂量并更快地减少阿片类药物用量。本研究调查了COLP对10至17岁因青少年特发性脊柱侧凸(AIS)接受后路融合手术患者术后治疗的有效性。这是一项对64例AIS患者进行的随机对照试验,患者被分配到两个组之一:COLP+常规治疗(TAU)组和TAU对照组。随机分组和基线评估在术前访视时进行。住院后每周记录阿片类药物的消耗量,直至术后6周的首次术后当面访视。主要结局指标是术后阿片类药物的消耗量,包括用量和持续时间。次要结局包括疼痛、功能能力和心理健康评分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffd0/12218585/bcadc895341a/IPMT_A_2520148_F0001_OC.jpg

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