Repeated Dexmedetomidine Infusion is a Two-shot Weapon for Pain and Pain-induced Mood Disorders in Chronic Pain Patients: A Placebo-controlled Randomized Prospective Interventional Study

Abstract

Objectives: This prospective study examined the effects of 6-sessions of dexmedetomidine (DEX) for patients had chronicmusculoskeletal pain (CMSP) on the frequency and severity ofpain, and pain-induced depression, anxiety and kinesiophobia.Patients & Methods: 80 CMSP patients were evaluated usingthe short-form McGill Pain Questionnaire (SF-MPQ), PainAnxiety Symptoms Scale (PASS), State-Trait Anxiety Inventoryfor measuring state and trait anxiety, short-form Tampa Scale ofKinesiophobia and Beck Depression Inventory-II. Patients wererandomly divided into Group-C received placebo infusion andGroup-S received DEX infusion (0.7 ?g/kg for 1-hour) twiceweekly for three weeks. Evaluations were re-assessed at the endof infusion (T2), 1-m (T3) and 3-m (T4) in comparison to scoresdetermined before start of infusion therapy (T1).Results: At T2-T4 the scores of all the evaluated toolsdecreased significantly in Group-S compared their T1 scores andto scores of patients of Group-C. Moreover, 47.5% of Group-Spatients were independent on any analgesia since T2 till T4 withsignificant difference compared to Group-C patients and to theirconsumption rate and type of analgesia at T1. Satisfaction scoresof Group-S patients by the infusion therapy were significantlyhigher compared to that of patients of Group-C and to their T1scores by the usual analgesia. The re-assessed scores werenegatively correlated with the administration of DEX infusionand positively correlated with the decrease in pain scores. ROCcurve analysis defined decreased kinesiophobia scores as thesignificant predictor for the decreased depression scores to 0-13.Conclusion: DEX infusion might break the circle of painpsychopathy-poor quality of life of CMSP patients. Allpsychological scorings were improved secondary to improvedpain scores but improved kinesiophobia is the significantpredictor for alleviation of depression.