Journal
JOURNAL OF PAIN
Volume 9, Issue 9, Pages 856-862Publisher
CHURCHILL LIVINGSTONE
DOI: 10.1016/j.jpain.2008.04.006
Keywords
narcotic analgesia; functional capacity evaluation; work-related function; lumbar spine; work ability
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Funding
- University of Alberta
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We studied the impact of acute opioid administration on work-related exercise performance in patients with chronic back pain. A double-blinded, random-order, placebo-controlled, crossover trial was conducted. Subjects were predominately men (63%), with a mean age of 49 years. Subjects performed a continuous lifting and lowering test to voluntary fatigue at a load equivalent to 33% of their predetermined maximal lifting load twice: Once after receiving a single intravenous dose of 1 mu g/kg fentanyl (a narcotic analgesic) and once after saline placebo. Of the 30 subjects undergoing testing, 3 subjects were unable to complete testing due to medication-induced nausea. Subjects lifted on average 29.4 +/- 17.9 kg under the influence of fentanyl versus 25.6 +/- 3.1 kg with placebo (effect size = 0.23). Time to fatigue was higher in the fentanyl group (312 +/- 251.4 vs 231 +/- 199.9 seconds, effect size = 0.40), and these subjects also performed more total work (7004 +/- 5144 vs 4748 +/- 3147 J, effect size = 0.72). Opioid analgesia improves lifting performance in the short term in individuals with chronic back pain. Longer trials of the effectiveness of opioid analgesia as an adjunct to functional restoration programs are recommended. Perspective: This article presents the results of a clinical trial showing that acute opioid administration improves work-related exercise performance in individuals with chronic back pain. Longer trials of the effectiveness of opioid analgesia as an adjunct to functional restoration programs are recommended. (C) 2008 by the American Pain Society.
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