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L’effet placebo dans le traitement de la douleur

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Résumé

Les auteurs analysent plusieurs études cliniques concernant les effets analgésiques du placebo dans le traitement de la douleur. Mimant les effets antalgiques de la thérapeutique verum prescrite, le placebo induit une analgésie importante en moyenne chez 35% des patients avec des variations selon la pathologie étudiée et les modalités du traitement utilisé. L’effect placebo est surtout influencé par les attentes et les convictions du patient, du médecin et de l’entourage et par la qualité de la relation médecin-malade. Correspondant à une véritable analgésie psychogène, il pourrait agir en partie par une libération de substances opioïdes endogènes et aussi peut-être par d’autres actions neuroendocriniennes restant à explorer.

Par la qualité de la relation avec son patient, et par des propositions thérapeutiques adaptées aux attentes et convictions de celui-ci, le médecin peut accroître son efficacité thérapeutique en ajoutant un puissant effect placebo aux effects spécifiques de son traitement.

Summary

The authors analyse several clinical studies in connection with the analgesic effects of placebo.

Copying the analgesic effects of the prescribed therapeutic, the placebo induces a significant analgesia on an average 35% of patients, or some variations according to the studied pathology and the modalities of the used treatment. The placebo effect is especially influenced by the expectations and the beliefs of the patient, the doctor, the circle and the quality of the relation patient-doctor.

Like a real psychogen analgesia, the placebo could act partly by a liberation of endogenous opioid substances and partly by others neuro-endocrinian activities not yet explored. By the quality of the communication with the patient and by the therapeutic resolutions suitable for his expectation and his belief, the doctor induces an important placebo effect and like that increases the specific effects of his treatment.

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Bibliographie

  1. 1.

    Beecher H. K.: The powerful placebo.JAMA 159, 1602–1606, 1955.

  2. 2.

    Beecher H. K.: Evidence for increased effectiveness of placebos with increased stress.Am. J. Physiology 187, 163–169, 1956.

  3. 3.

    Bilsback P., Rolly G. andTampulolon O.: Efficacy of the extradural administration of lofentanil, buprenorphine or saline in the management of post-operative pain.Brit. J. Anaesth. 57, 943–948, 1985.

  4. 4.

    Boureau F., Leizorovicz A. etCaulin F.: Effet placebo et douleurs métastatiques osseuses.Press. Med. (à paraître en 1988).

  5. 5.

    Branthwaite A. andCooper P.: Analgesic effects of branding in treatment of headaches.Brit. Med. J. 282, 1576–1578, 1981.

  6. 6.

    Chadha D. R. andDasilva L. M.: The placebo in clinical psychopharmacology.Current Therapeutic Research 21, 748–752, 1977.

  7. 7.

    Chen A. C. N. andDworkin S. F.: Cognitive Synergism of Pharmacological Analgesia: A new form for analgesic treatment.In:Advances in Pain Research and Therapy 5, J. J. Bonica et al, Ed. Raven Press, New York, p. 839–845, 1983.

  8. 8.

    Cleghom R. A., Graham B. F., Campbell R. B., Rubleaa N. K., Elliott F. H. andSafran M.: Anxiety states: their response to ACTH and to isotonic saline. In:Proced First Clin. ACTH. Conf. Blakiston, Philadelphia, p. 561–565, 1950.

  9. 9.

    Cobb L. A., Thomas G. I. andDillard D. H.: An evaluation of internal mammary artery ligation by a double blind technic.New Engl. J. Med. 260, 1115–1118, 1959.

  10. 10.

    Conference on Therapy: The use of placebos in therapy. New York State.J. Med. 46, 1718–1727, 1946.

  11. 11.

    Dimond E. G., Kittle C. F. andCrackett J. E.: Comparison of internal mammary artery ligation and sham operation for angina pectoris.Am. J. Cardiology 5, 483–486, 1960.

  12. 12.

    Evans F. J.: Placebo response: relationship to suggestibility and hyponotizability.Proceedings of the 77th Annual Convention of the American Psychological Association 4, 889–890, 1969.

  13. 13.

    Evans F. J.: The placebo response in pain reduction.In:Adv. Neurol. 4, Raven Press, New York, 289–296, 1974.

  14. 14.

    Evans F. J.: Expectancy, therapeutic instructions and the placebo response,.In: Placebo: Theory, Research and Mechanisms. Ed. L. White, B. Tursky, G. E. Schwartz. Guilford Press, p. 215–228, 1985.

  15. 15.

    Gerard M. J., Serrurier D. etLaplanche C.: Influence de la nature de l’affection traitée sur l’effet placebo dans les essais d’anti-inflammatoires non stéroïdiens.Therapie 38, 415–418, 1983.

  16. 16.

    Gracely R. H., Dubner R., Wolskee P. J. andDeeter W. R.: Placebo and naloxone can alter post-surgical pain by separate mechanisms.Nature 306, London, 264–265, 1983.

  17. 17.

    Gracely R. H., Dubner R., Deeter W. R. andWolskee P. J.: Clinicians’ expectations influence placebo analgesia.Lancet 1, 43, 1985.

  18. 18.

    Grevert P., Albert L. H. andGoldstein A.: Partial antagonism of placebo analgesia by naloxone.Pain 16, 129–143, 1983.

  19. 19.

    Gryll S. L. andDasilva L. M.: The placebo effect in clinical psychopharmacology.Current Therapeutic Research 21, 748–752, 1977.

  20. 20.

    Hashish I., Harvey W. andHarris M.: Antiinflammatory effects of ultrasound therapy: Evidence for a major placebo effect.Brit. J. Rheumatology 25, 77–81, 1986.

  21. 21.

    Hill R. C. andTurner P.: Importance of initial pain in post-operative assessment of analgesic drugs.J. Clin. Pharmacol. 9, 321–327, 1969.

  22. 22.

    Houde R. W., Wallenstein S. L. andRogers A.: Clinical pharmacology of analgesics. A method of asseying analgesic effect.Clin. Pharmacol. Ther. 1, 163–174, 1960.

  23. 23.

    Houde R. W., Wallenstein S. L. andBeaver W. T.: Clinical measurement of pain. In: De Stevens Ed., Analgetics, New York Academic Press, p. 75–122, 1965.

  24. 24.

    Kreitler S., Kreitler H. andCarasso R.: Cognitive orientation as predictor of pain relief following acupuncture.Pain 28, 323–341, 1987.

  25. 25.

    Langley G. B., Sheppeard H. andWigley R. D.: Placebo therapy in rhumatoid arthritis.Clinical and Experimental Rhumatology 1, 17–21, 1983.

  26. 26.

    Lasagna L., Mosteller F., Von Felsinger J. M. andBeecher H. K.: A study of the placebo response.Am J. Med. 16, 770–779, 1954.

  27. 27.

    Levine J. D., Gordon N. C. andFields H. L.: The mechanism of placebo analgesia.Lancet 2, 654–657, 1978.

  28. 28.

    Levine J. D., Gordon N. C., Bornstein J. C. andFields H. L.: Role of pain in placebo analgesia.Proc. Natl. Acad. Sci. USA76, 3528–3531, 1979.

  29. 29.

    Loan W. B., Morrisson J. D. andDundee J. W.: Evaluation of a method for assessing potent analgesics.Clin. Pharmacol. Ther. 9, 765–776, 1968.

  30. 30.

    Mc Glashan T. H., Evans F. J. andOrne M. T.: The nature of hypnotic analgesic and placebo response to experimental pain.Psychosomatic Medicine 31, 227–246, 1969.

  31. 31.

    Moertel C. G., Taylor W. F., Roth A andTyce F. A. J.: Who responds to sugar pills?Mayo Clin. Proc. 51, 96–100, 1976.

  32. 32.

    Nathan P. W.: Success in surgery may not require cutting the tracts.Pain 22, 317–319, 1985.

  33. 33.

    Pichot P.: A propos de l’effet placebo.Rev. Med. Psychosom. 3, 37–40, 1961.

  34. 34.

    Ricker K., Clark E. L., Etezady M. H et al.: Butabarbital sodium and chloridazepoxide in anxious patients: a collaborative control study.Clin. Pharmacol. Ther. 11, 538–550, 1970.

  35. 35.

    Shapiro A. K.: The placebo effect in the history of medical treatment: Implication for psychiatry.Am. J. Psychiatry 116, 298–304, 1959.

  36. 36.

    Shapiro A. K.: Factors contributing to the placebo effect.Am. J. Psychotherapy 18, 73–88, 1964.

  37. 37.

    Spriet A. etSimon P.: Placebos et effets placebos.Rev. Med. 7, 341–348, 1978.

  38. 38.

    Thorsteinsson G., Stonnington H., Stiwell G. K. andElveback L. R.: The placebo effect of transcutaneous electrical stimulation.Pain 5, 31–41, 1978.

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Correspondence to J. Bruxelle.

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Bruxelle, J., Marquez, C. & Valade, D. L’effet placebo dans le traitement de la douleur. Doul. et Analg. 1, 19–25 (1988). https://doi.org/10.1007/BF03007377

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Key words

  • Placebo
  • pain
  • analgesia
  • endorphines