Lim Alan T, Edis Geraldine, Kranz Henryk, Mendelson George, Selwood Tom, Scott David F
Pain Study Group, Prince Henry's and Alfred Hospitals, Melbourne, Victoria Australia.
Pain. 1983 Oct;17(2):179-188. doi: 10.1016/0304-3959(83)90141-0.
The influence of transcutaneous electrical stimulation (TES) and psychological factors in determining the intensity of acute postoperative pain was examined in a prospective, double-blind controlled trial completed by 30 patients having elective surgery. Psychometric tests were administered prior to surgery. Postoperative pain was assessed by cumulative morphine requirement (M48) administered intramuscularly, and the mean score of a visual analogue scale of pain (VAS), in the first 48 h following surgery. M48 was significantly correlated with the VAS score (r = 0.62, P less than 0.001), and with the psychometric test scores for trait-anxiety (r = 0.70, P less than 0.001) and neuroticism (r = 0.67, P less than 0.001). Though patients treated with TES required 25% less morphine than those treated with placebo, the difference was not significant using monovariate analysis and applying unpaired two-tailed Student's t-test (P less than 0.2). When the contribution of neuroticism to the variance of M48 was adjusted using multiple regression analysis, the effect of TES became significant at the 0.05 level. Covariance analysis showed that TES contributed some 19% to the explained variance of M48 while neuroticism contributed about 80%, and there was no interaction between these two factors. These findings allow a degree of prediction of the individual patient's postoperative pain and narcotic requirement, and point to a strong correlation between postoperative pain perception and personality.
在一项由30名接受择期手术的患者完成的前瞻性双盲对照试验中，研究了经皮电刺激（TES）和心理因素对确定急性术后疼痛强度的影响。术前进行心理测试。术后疼痛通过术后前48小时肌肉注射的累积吗啡需求量（M48）以及视觉模拟疼痛量表（VAS）的平均得分进行评估。M48与VAS评分显著相关（r = 0.62，P < 0.001），与特质焦虑的心理测试评分（r = 0.70，P < 0.001）和神经质的心理测试评分（r = 0.67，P < 0.001）也显著相关。尽管接受TES治疗的患者所需吗啡比接受安慰剂治疗的患者少25%，但使用单变量分析和未配对双尾学生t检验时，差异不显著（P < 0.2）。当使用多元回归分析调整神经质对M48方差的贡献时，TES的效果在0.05水平上变得显著。协方差分析表明，TES对M48的解释方差贡献约为19%，而神经质贡献约为80%，这两个因素之间没有相互作用。这些发现可以在一定程度上预测个体患者的术后疼痛和麻醉剂需求量，并表明术后疼痛感知与个性之间存在很强的相关性。
