Reddy S, Patt R B
University of Texas M.D. Anderson Cancer Center, Houston.
J Pain Symptom Manage. 1994 Nov;9(8):510-4. doi: 10.1016/0885-3924(94)90112-0.
There has been long-standing debate regarding whether benzodiazepines possess analgesic properties that are independent of their effects on mood and alertness. A careful review of the literature reveals insufficient evidence to support the contention that the benzodiazepines have meaningful analgesic properties in most clinical circumstances. Treatment with the benzodiazepines may reduce complaints of pain, but this seems to be an indirect effect related to their psychotropic properties, such as alleviation of anxiety and, in selected cases, depression. In the absence of definitive data, clinical experience suggests a potential role for treatment with benzodiazepines for acute muscle spasm, concomitant chronic pain and anxiety, and lancinating neropathic pain, in which case clonazepam and alprazolam may be the agents of choice. They should probably not be considered as first-line choices even for the above indications, since potential benefits must be considered in the context of potential for the development of cognitive impairment, physical and psychological dependence, worsening depression, overdose, and other side effects.
关于苯二氮䓬类药物是否具有独立于其对情绪和警觉性影响的镇痛特性，一直存在长期争论。对文献的仔细回顾显示，没有足够的证据支持苯二氮䓬类药物在大多数临床情况下具有有意义的镇痛特性这一论点。使用苯二氮䓬类药物进行治疗可能会减少疼痛主诉，但这似乎是一种与其精神otropic特性相关的间接效应，例如减轻焦虑，在某些情况下还可减轻抑郁。在缺乏确凿数据的情况下，临床经验表明，苯二氮䓬类药物可用于治疗急性肌肉痉挛、伴发的慢性疼痛和焦虑以及刺痛性神经性疼痛，在这种情况下，氯硝西泮和阿普唑仑可能是首选药物。即使对于上述适应症，它们可能也不应被视为一线选择，因为必须在认知障碍、身体和心理依赖、抑郁加重、过量用药及其他副作用发生可能性的背景下考虑潜在益处。
