"Anxiebo", placebo, and postoperative pain

<p>Abstract</p> <p>Background</p> <p>Surgical treatment and its consequences expose patients to stress, and here we investigated the importance of the psychological component of postoperative pain based on reports in the clinical literature.</p> <p>Discussio...

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Main Authors: Gordh Torsten, Ingvar Martin, Svedman Paul
Format: Article
Language:English
Published: BMC 2005-06-01
Series:BMC Anesthesiology
Online Access:http://www.biomedcentral.com/1471-2253/5/9
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author Gordh Torsten
Ingvar Martin
Svedman Paul
author_facet Gordh Torsten
Ingvar Martin
Svedman Paul
author_sort Gordh Torsten
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Surgical treatment and its consequences expose patients to stress, and here we investigated the importance of the psychological component of postoperative pain based on reports in the clinical literature.</p> <p>Discussion</p> <p>Postoperative pain remains a significant clinical problem. Increased pain intensity with increased demand for opioid medication, and/or a relative unresponsiveness to pain treatment was reported both when the analgesia was administered by means of conventional nurse injection regimes and patient-controlled analgesia (PCA). Both the quality of the analgesia, and the sensitivity of postoperative models for assessing analgesic efficacy could be significantly influenced.</p> <p>The findings could be explained by increased penetration of an algesic anxiety-related nocebo influence (which we chose to call "anxiebo") relative to its analgesic placebo counterpart. To counteract this influence, the importance of psychological effects must be acknowledged, and doctors and attending nurses should focus on maintaining trustful therapist-patient relationships throughout the treatment period. The physical mechanism of anxiebo should be further explored, and those at risk for anxiebo better characterized. In addition, future systemic analgesic therapies should be directed towards being prophylactic and continuous to eliminate surgical pain as it appears in order to prevent the anxiebo effect.</p> <p>Addressing anxiebo is the key to developing reproducible models for measuring pain in the postoperative setting, and to improving the accuracy of measurements of the minimum effective analgesic concentration.</p> <p>Summary</p> <p>Anxiebo and placebo act as counterparts postoperatively. The anxiebo state may impair clinical analgesia and reduce the sensitivity of analgesic trials. Ways to minimize anxiebo are discussed.</p>
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spelling doaj.art-b10520affda14f0ea4031b0489ecd72a2022-12-22T03:11:35ZengBMCBMC Anesthesiology1471-22532005-06-0151910.1186/1471-2253-5-9"Anxiebo", placebo, and postoperative painGordh TorstenIngvar MartinSvedman Paul<p>Abstract</p> <p>Background</p> <p>Surgical treatment and its consequences expose patients to stress, and here we investigated the importance of the psychological component of postoperative pain based on reports in the clinical literature.</p> <p>Discussion</p> <p>Postoperative pain remains a significant clinical problem. Increased pain intensity with increased demand for opioid medication, and/or a relative unresponsiveness to pain treatment was reported both when the analgesia was administered by means of conventional nurse injection regimes and patient-controlled analgesia (PCA). Both the quality of the analgesia, and the sensitivity of postoperative models for assessing analgesic efficacy could be significantly influenced.</p> <p>The findings could be explained by increased penetration of an algesic anxiety-related nocebo influence (which we chose to call "anxiebo") relative to its analgesic placebo counterpart. To counteract this influence, the importance of psychological effects must be acknowledged, and doctors and attending nurses should focus on maintaining trustful therapist-patient relationships throughout the treatment period. The physical mechanism of anxiebo should be further explored, and those at risk for anxiebo better characterized. In addition, future systemic analgesic therapies should be directed towards being prophylactic and continuous to eliminate surgical pain as it appears in order to prevent the anxiebo effect.</p> <p>Addressing anxiebo is the key to developing reproducible models for measuring pain in the postoperative setting, and to improving the accuracy of measurements of the minimum effective analgesic concentration.</p> <p>Summary</p> <p>Anxiebo and placebo act as counterparts postoperatively. The anxiebo state may impair clinical analgesia and reduce the sensitivity of analgesic trials. Ways to minimize anxiebo are discussed.</p>http://www.biomedcentral.com/1471-2253/5/9
spellingShingle Gordh Torsten
Ingvar Martin
Svedman Paul
"Anxiebo", placebo, and postoperative pain
BMC Anesthesiology
title "Anxiebo", placebo, and postoperative pain
title_full "Anxiebo", placebo, and postoperative pain
title_fullStr "Anxiebo", placebo, and postoperative pain
title_full_unstemmed "Anxiebo", placebo, and postoperative pain
title_short "Anxiebo", placebo, and postoperative pain
title_sort anxiebo placebo and postoperative pain
url http://www.biomedcentral.com/1471-2253/5/9
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