Haythornthwaite J A, Menefee L A, Quatrano-Piacentini A L, Pappagallo M
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Pain Symptom Manage. 1998 Mar;15(3):185-94. doi: 10.1016/s0885-3924(97)00352-7.
Potential iatrogenic mood and cognitive declines associated with long-acting opioid therapy were examined in 19 patients receiving long-acting oral opioid medications and compared to ten patients receiving usual care. Pain, mood, and cognitive function were measured before and after achieving stable doses. In addition to reducing pain, long-acting opioid medication reduced anxiety and hostility. No declines in cognitive function were associated with the long-acting opioid medications, and the group receiving long-acting opioid medications showed significant improvement on a measure of psychomotor speed and sustained attention. Both patient groups reported significant reductions in perceived impairment in daily activities due to pain. Treatment responders taking long-acting opioid medications (63%) were taking a significantly lower dose at follow-up than the treatment non-responder group. These findings suggest that long-acting opioid medications can improve mood and do not impair cognitive functioning in patients with chronic non-cancer pain.
对19名接受长效口服阿片类药物治疗的患者进行了与长效阿片类药物治疗相关的潜在医源性情绪和认知衰退的研究，并与10名接受常规护理的患者进行了比较。在达到稳定剂量前后测量疼痛、情绪和认知功能。除了减轻疼痛外，长效阿片类药物还减轻了焦虑和敌意。认知功能的下降与长效阿片类药物无关，接受长效阿片类药物治疗的组在一项心理运动速度和持续注意力测试中表现出显著改善。两个患者组均报告因疼痛导致的日常活动感知障碍显著减少。接受长效阿片类药物治疗的治疗反应者（63%）在随访时服用的剂量明显低于治疗无反应组。这些发现表明，长效阿片类药物可以改善情绪，并且不会损害慢性非癌性疼痛患者的认知功能。
