Cooper S A
Am J Med. 1983 Nov 14;75(5A):24-9. doi: 10.1016/0002-9343(83)90229-2.
Renewed interest in analgesic models has been stimulated by the development of several new nonsteroidal anti-inflammatory drugs. Many of these new analgesic agents appear to have higher peak effects and longer durations of action than acetylsalicylic acid. Sensitive models are necessary to determine the dose-effect relationships and relative analgesic efficacies of these new agents. The basic principles of clinical methods--double-blinding, identical appearance of study medications, and random allocation of treatments to subjects--must be adhered to. However, additional precautions must also be taken. The choice of pain models and further subdivision of subjects within a pain model are critical for assay sensitivity. The dental pain model has become popular because the surgical procedures can be easily categorized, and each subpopulation is relatively homogeneous. There now is a body of data that substantiates the assay sensitivity of the dental pain model, and its usefulness in predicting the general analgesic efficacy of nonsteroidal anti-inflammatory drugs. Other pain models, including general postsurgical, orthopedic postsurgical, and postpartum pain, also have demonstrated adequate assay sensitivity to determine the relative efficacy of new nonsteroidal anti-inflammatory drugs.
几种新型非甾体抗炎药的研发激发了人们对镇痛模型的新兴趣。与阿司匹林相比，这些新型镇痛药中的许多似乎具有更高的峰值效应和更长的作用持续时间。灵敏的模型对于确定这些新药的剂量效应关系和相对镇痛效果是必要的。必须遵循临床方法的基本原则——双盲、研究药物外观相同以及治疗对受试者的随机分配。然而，还必须采取额外的预防措施。疼痛模型的选择以及疼痛模型内受试者的进一步细分对于检测灵敏度至关重要。牙科疼痛模型已变得很流行，因为手术程序易于分类，且每个亚组相对同质。现在有大量数据证实了牙科疼痛模型的检测灵敏度及其在预测非甾体抗炎药总体镇痛效果方面的有用性。其他疼痛模型，包括一般手术后疼痛、骨科手术后疼痛和产后疼痛，也已证明具有足够的检测灵敏度来确定新型非甾体抗炎药的相对疗效。
