Dworkin S F, Chen A C N, Schubert M M, Clark D W
Pain Center, University of Washington, Seattle, WA 98195 U.S.A. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195 U.S.A. Department of Oral Medicine, University of Washington, Seattle, WA 98195 U.S.A. Department of Psychology, University of Washington, Seattle, WA 98195 U.S.A.
Pain. 1984 Aug;19(4):339-351. doi: 10.1016/0304-3959(84)90080-0.
The present study sought to discover whether information clarifying how the analgesic/sedative drug nitrous oxide (N2O) works would result in increased analgesic responses to painful stimuli when various concentrations of N2O were administered. Subjects were provided with high and low levels of information regarding the action and use of N2O as an analgesic and sedative. Absolute sensation threshold (AST), pain threshold (PTh), and pain tolerance (PTo) to tooth pulp shock were measured in microamperes during administration of each of 3 concentrations of N2O (15%, 30%, and 45%, with oxygen). Subjects rated stimulus intensity and stimulus aversiveness in response to a fixed painful stimulus, and completed questionnaires regarding the perceived efficacy of N2O and their subjective mood state throughout the session. The marked differences observed in pain reports between the high information group and the control group confirm that providing information to people receiving a drug for pain relief yields higher sensation thresholds, pain thresholds, and tolerance of pain. In addition, we observed that in the presence of N2O an equivalent fixed painful stimulus will be perceived as less painful after appropriate information is provided. These findings suggest that experimentally influencing thought processes, in combination with an analgesic, can have the effect of increasing analgesia.
本研究旨在探究,当给予不同浓度的镇痛/镇静药物一氧化二氮(N₂O)时,阐明该药物作用机制的信息是否会增强对疼痛刺激的镇痛反应。研究人员向受试者提供了关于N₂O作为镇痛和镇静药物的作用及用法的详细程度不同的信息。在给予三种浓度(15%、30%和45%,均与氧气混合)的N₂O过程中,以微安为单位测量受试者对牙髓电击的绝对感觉阈值(AST)、疼痛阈值(PTh)和疼痛耐受度(PTo)。受试者对固定疼痛刺激的强度和厌恶程度进行评分,并在整个实验过程中完成关于N₂O的感知疗效及其主观情绪状态的问卷。高信息组与对照组在疼痛报告中观察到的显著差异证实,向接受缓解疼痛药物治疗的人提供信息会产生更高的感觉阈值、疼痛阈值和疼痛耐受度。此外,我们观察到,在有N₂O存在的情况下,提供适当信息后,同等强度的固定疼痛刺激会被感知为疼痛减轻。这些发现表明,通过实验影响思维过程,并结合使用镇痛药,可产生增强镇痛效果的作用。