Laska E M, Sunshine A, Wanderling J A, Meisner M J
J Clin Pharmacol. 1982 Nov-Dec;22(11-12):531-42. doi: 10.1002/j.1552-4604.1982.tb02646.x.
An analysis was made of data from over 4000 postepisiotomy, uterine cramping, and postsurgical patients complaining of moderate or severe pain. They had received 325, 650, or 1300 mg aspirin or placebo while they were subjects in 10 analgesic clinical trials. On the average, for the same verbally expressed pain intensity level and the same treatment, more relief was obtained by a patient with uterine cramping than one with episiotomy pain, who in turn obtained more relief than a patient with surgical pain. A new mathematical model which characterizes the probability that an analgesic provides complete relief as a function of dose, severity of pain intensity, and pain etiology is developed. The model utilizes the data itself to estimate the numerical score corresponding to verbal pain intensities. The results indicate that the numerical score quantifying severe surgical pain is 1.4 times greater than the score for severe episiotomy pain, which in turn is 3.2 times greater than the score for severe uterine cramping. Clinical trials must be designed to take these differences into account. Also, clinicians must be cognizant of such differences when choosing among drugs and dosages for patients with different pain intensity and etiology.
对4000多名接受会阴切开术、子宫绞痛及术后主诉中度或重度疼痛的患者的数据进行了分析。在10项镇痛临床试验中，这些患者作为受试者时接受了325毫克、650毫克或1300毫克阿司匹林或安慰剂治疗。平均而言，对于相同口头表述的疼痛强度水平和相同治疗，子宫绞痛患者比会阴切开术疼痛患者获得的缓解更多，会阴切开术疼痛患者又比手术疼痛患者获得的缓解更多。开发了一种新的数学模型，该模型将镇痛药提供完全缓解的概率表征为剂量、疼痛强度严重程度和疼痛病因的函数。该模型利用数据本身来估计与口头疼痛强度相对应的数值分数。结果表明，量化严重手术疼痛的数值分数比严重会阴切开术疼痛的分数高1.4倍，而严重会阴切开术疼痛的分数又比严重子宫绞痛的分数高3.2倍。必须设计临床试验以考虑这些差异。此外，临床医生在为不同疼痛强度和病因的患者选择药物和剂量时必须认识到这些差异。
