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Influence du placebo-répondeur dans l’évaluation de l’effet antalgique de l’aspirine (acide acétylsalicylique)

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Douleur et Analgésie

Résumé

Nous avons étudié, en double aveugle, l’effet antinociceptif de l’acide acétylsalicylique dosé à 0,6 g et d’un placebo (lactose) sur une douleur expérimentale dentaire chez 17 sujets normaux. Le placebo, comme l’acide acétylsalicylique, produit une réponse analgésique statistiquement significative par comparaison avec les réponses de contrôle obtenues au cours des séances sans traitement. La comparaison des réponses analgésiques au placebo et à l’acide acétylsalicylique ne montre pas de différence significative pour l’ensemble de la population. Par contre, après avoir séparé les sujets en «placebo-répondeurs» et «placebo-non-répondeurs», nous avons pu mettre en évidence un effet analgésique de l’acide acétylsalicylique statistiquement supérieur à celui du placebo dans le groupe «placebo-non-répondeur». Aucune différence significative entre l’effet du placebo et celui de l’acide acétylsalicylique ne peut être montrée dans le groupe «placebo-répondeur». Ainsi, la séparation des sujets en placebo-répondeurs et placebo-non-répondeurs permet de démasquer l’effet antinociceptif de substances à faible pouvoir pharmacologique.

Summary

Placebo and acetylsalicylic acid (0.6 gm) analgesic effects were studied in double blind in a within-subject-repeated-measures experiment using an experimental dental pain test in 17 normal subjects. Compared to the no-treatment condition, both treatments produced significant analgesic effects. The placebo analgesic effect was very powerful and no statistical difference was found between placebo and aspirin data for the whole population. However, after separating the 17 subjects into placebo-responders (PR) and placebo-non-responders (PNR), significant difference between placebo and aspirin effects was elicited in the PNR group, whereas no statistical difference was found in the PR group. This result is in accordance with previous studies, which have shown that, when the PR subjects are screened out, more precise information can be obtained in pharmacological studies.

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  1. Départment de psychiatrie, Beth Israel Medical Center, First Ave. 16th street, 10003, New York, NY, USA

    M. Ernst

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Ernst, M. Influence du placebo-répondeur dans l’évaluation de l’effet antalgique de l’aspirine (acide acétylsalicylique). Doul. et Analg. 1, 27–33 (1988). https://doi.org/10.1007/BF03007378

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  • DOI: https://doi.org/10.1007/BF03007378

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