Elevated Pain Sensitivity in Chronic Pain Patientsat Risk for Opioid
Robert R. Edwards. Ajay D. Wasan. Ed Michna. Seth Greenbaum. Ed Ross.
and Robert N. Jamison
Department ofAnesthesiology. Harvard Medical School.Brigham & Women’sHospital. Chestnut Hill. Massachusetts.
Abstract: This study employed quantitative sensory testing (QST) to evaluate pain responses in
chronic spinal pain patients at low risk and high risk for opioid misuse. with risk classi?cation based
on scores on the Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R). Patients
were further subgrouped according to current use of prescription opioids. Of the 276 chronic pain
patients tested. approximately 65% were taking opioids; a median split was used to further categorize
these patients as being on lower or higher doses of opioids. The high-risk group (n = 161) reported
higher levels of clinical pain. had lower pressure and thermal pain thresholds at multiple
body sites. had lower heat pain tolerance. and rated repetitive mechanical stimuli as more painful
relative to the low-risk group (n = 115; P’s < .01). In contrast. QST measures did not differ across
opioid groups. Multiple linear regression analysis suggested that indices of pain-related distress
(ie. anxiety and catastrophizing about pain) were also predictive of hyperalgesia. particularly in patients
taking opioids. Collectively. regardless of opioid status. the high-risk group was hyperalgesic
relative to the low-risk group; future opioid treatment studies may bene?t from the classi?cation
of opioid risk. and the examination of pain sensitivity and other factors that differentiate highand
Perspective: This study demonstrates that chronic spinal pain patients at high risk for misuse of
taking opioids. Indices of pain-related distress were important predictors of pain sensitivity.
particularly among those patients taking opioids for pain.
위 논문은 MEDOC사의 Q-sense관련 논문입니다.