Conditioned open-label placebo for opioid reduction after spine surgery: a randomized controlled trial.
Journal
Pain
ISSN: 1872-6623
Titre abrégé: Pain
Pays: United States
ID NLM: 7508686
Informations de publication
Date de publication:
01 06 2021
01 06 2021
Historique:
received:
05
10
2020
accepted:
31
12
2020
pubmed:
16
1
2021
medline:
20
5
2021
entrez:
15
1
2021
Statut:
ppublish
Résumé
Placebo effects have traditionally involved concealment or deception. However, recent evidence suggests that placebo effects can also be elicited when prescribed transparently as "open-label placebos" (OLPs), and that the pairing of an unconditioned stimulus (eg, opioid analgesic) with a conditioned stimulus (eg, placebo pill) can lead to the conditioned stimulus alone reducing pain. In this randomized control trial, we investigated whether combining conditioning with an OLP (COLP) in the immediate postoperative period could reduce daily opioid use and postsurgical pain among patients recovering from spine surgery. Patients were randomized to COLP or treatment as usual, with both groups receiving unrestricted access to a typical opioid-based postoperative analgesic regimen. The generalized estimating equations method was used to assess the treatment effect of COLP on daily opioid consumption and pain during postoperative period from postoperative day (POD) 1 to POD 17. Patients in the COLP group consumed approximately 30% less daily morphine milligram equivalents compared with patients in the treatment as usual group during POD 1 to 17 (-14.5 daily morphine milligram equivalents; 95% CI: [-26.8, -2.2]). Daily worst pain scores were also lower in the COLP group (-1.0 point on the 10-point scale; 95% CI: [-2.0, -0.1]), although a significant difference was not detected in average daily pain between the groups (-0.8 point; 95% CI: [-1.7, 0.2]). These findings suggest that COLP may serve as a potential adjuvant analgesic therapy to decrease opioid consumption in the early postoperative period, without increasing pain.
Identifiants
pubmed: 33449503
doi: 10.1097/j.pain.0000000000002185
pii: 00006396-202106000-00025
pmc: PMC8378225
mid: NIHMS1720775
doi:
Substances chimiques
Analgesics
0
Analgesics, Opioid
0
Banques de données
ClinicalTrials.gov
['NCT04574388']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1828-1839Subventions
Organisme : NIGMS NIH HHS
ID : K23 GM110540
Pays : United States
Informations de copyright
Copyright © 2021 International Association for the Study of Pain.
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