Placeboeffekte bei chronischen Schmerzen: Forschungsstand und klinische Anwendung

Maike Müller; Anne-Kathrin Bräscher

doi:10.1055/s-0043-121683

AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie, Table of Contents

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53(09): 605-617
DOI: 10.1055/s-0043-121683

Topthema

CME-Fortbildung

Georg Thieme Verlag KG Stuttgart · New York

Placeboeffekte bei chronischen Schmerzen: Forschungsstand und klinische Anwendung

Placebo Responses in Chronic Pain: State of Research and Clinical Implications

Maike Müller

,

Anne-Kathrin Bräscher

Abstract

Zusammenfassung

Spielte der Placeboeffekt ehemals vorwiegend eine (eher unliebsame) Rolle bei randomisierten kontrollierten Studien, so treten nun vermehrt die mit dem Placeboeffekt verbundenen Chancen in den Vordergrund. Dieser Beitrag bespricht bisherige Forschungserkenntnisse zum Placeboeffekt bei chronischen Schmerzen und zeigt, wie durch eine gezielte Beeinflussung des therapeutischen Kontexts die Wirksamkeit pharmakologisch aktiver Schmerzmedikamente gesteigert werden kann.

Abstract

Placebo hypoalgesia has been found to play an important role in every health care by modulating patientsʼ responses to pharmacologically active analgesic treatments. It may be seen as reflecting the capacity for endogenous pain modulation. Enhancing the efficacy of analgesic treatments by boosting endogenous pain modulation might be particularly relevant for chronic pain patients. Research into placebo hypoalgesic responses to chronic pain is sparse, however. In healthy subjects, placebo hypoalgesia is induced by expectations of pain relief through verbal information and learning experiences. Here we review the existing evidence on placebo hypoalgesia to chronic pain. To our knowledge, placebo hypoalgesia to chronic pain has been investigated experimentally in chronic back and chronic musculoskeletal pain, neuropathic pain after thoracotomy, and episodic migraine. Results point towards a maintenance of placebo hypoalgesic responses in chronic pain populations, thus highlighting the potential benefit of boosting placebo hypoalgesic responses in the treatment of chronic pain. Strategies on boosting placebo hypoalgesic responses in every day healthcare are presented.

Schlüsselwörter

Placeboeffekt - Placebohypoalgesie - chronischer Schmerz - Erwartung - klassische Konditionierung

Key words

placebo effect - placebo hypoalgesia - chronic pain - expectation - classical conditioning

Full Text

References

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