Wallenstein S L
Cancer. 1984 May 15;53(10 Suppl):2260-6. doi: 10.1002/cncr.1984.53.s10.2260.
Measurement of pain in cancer patients requires all the procedural safeguards essential for the measurement of subjective responses, including the employment of active and inactive controls, double-blind techniques, randomization, and statistical verification of results. Pain is traditionally measured in analgesic studies by employing verbal descriptors of intensity, but more recently visual analogues of pain intensity have been used and generally provide more sensitive measures of pain intensity. Patients with chronic pain tend to rate the categories representing more intense pain as lower in the visual analogue scale than do patients with postoperative pain. This may well reflect differences in the prior pain experiences of the two groups. Patients with chronic cancer pain have greater positive mood effects after the narcotic, morphine, than after the non-steroidal antiinflammatory analgesic, zomepirac, and this appears to be independent of analgesic activity. It is possible to design crossover analgesic studies in cancer patients so as to minimize carry-over effects, and such studies are more efficient than parallel group assays. Crossover studies also provide the ability to measure carry-over when it occurs.
对癌症患者疼痛的测量需要所有用于测量主观反应的必要程序保障措施，包括使用活性和非活性对照、双盲技术、随机化以及结果的统计验证。在镇痛研究中，传统上通过使用强度的语言描述来测量疼痛，但最近已经使用了疼痛强度的视觉模拟量表，并且通常能提供更敏感的疼痛强度测量方法。与术后疼痛患者相比，慢性疼痛患者倾向于将视觉模拟量表中代表更强烈疼痛的类别评定为更低。这很可能反映了两组患者先前疼痛经历的差异。与使用非甾体抗炎镇痛药佐美酸相比，患有慢性癌症疼痛的患者在使用麻醉药吗啡后有更大的积极情绪影响，而且这似乎与镇痛活性无关。有可能为癌症患者设计交叉镇痛研究，以尽量减少残留效应，并且此类研究比平行组试验更有效。交叉研究还能够在残留效应出现时对其进行测量。
