Nocebo-induced Hyperalgesia During Local Anesthetic Injection

Varelmann, Dirk; Pancaro, Carlo; Cappiello, Eric; Camann, William

doi:10.1097/01.aoa.0000397164.02159.09

Cited by 41 publications

(69 citation statements)

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“…In one experiment, half of the participants were told before receiving an analgesic, “You are going to feel a big bee sting; this is the worst part of the procedure”, while the other half were told “We are going to give you a local anesthetic that will numb the area and you will be comfortable during the procedure”. Those patients who received the first description rated the painfulness of the injection as 5/10 on average, while the other group reported it as 3/10 on average 22. Similarly, in a powerful demonstration of the nocebo effect in practice, half of a group of men were told that they might experience sexual side effects as a result of a medication they were being prescribed, while the other half were not told.…”

Section: The Placebo Effectmentioning

confidence: 99%

Placebo effects and racial and ethnic health disparities: an unjust and underexplored connection

Friesen

Blease

2018

J Med Ethics

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While a significant body of bioethical literature considers how the placebo effect might introduce a conflict between autonomy and beneficence, the link between justice and the placebo effect has been neglected. Here, we bring together disparate evidence from the field of placebo studies and research on health inequalities related to race and ethnicity, and argue that, collectively, this evidence may provide the basis for an unacknowledged route by which health disparities are exacerbated. This route is constituted by an uneven distribution of placebo effects, resulting from differences in expressions of physician warmth and empathy, as well as support and patient engagement, across racial and ethnic lines. In a discussion of the ethical implications of this connection, we argue that this contribution to health disparities is a source of injustice, consider ways in which these disparities might be ameliorated and suggest that this conclusion is likely to extend to other realms of inequality as well.

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Section: The Placebo Effectmentioning

confidence: 99%

Placebo effects and racial and ethnic health disparities: an unjust and underexplored connection

Friesen

Blease

2018

J Med Ethics

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“…Patients who were receiving a local anaesthetic injection were given either a positive expectation: ‘we are going to inject the local anaesthetic that will numb the area and you will be comfortable during the procedure,’ or a negative expectation: ‘you are going to feel a big sting and burn in your back now, like a big bee sting; this is the worst part of the procedure’ (Varelmann et al ,36 p.868). Patients who received the negative information reported significantly greater pain from the injection than those who received more reassuring information.…”

Section: How Do Expectations Influence Symptom Reporting?mentioning

confidence: 99%

The nocebo effect: patient expectations and medication side effects

Faasse

Petrie

2013

Postgraduate Medical Journal

167

138

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Expectation of treatment side effects is consistently linked with those symptoms being realised. Patient expectations, including those generated by the informed consent process, can have a large influence on the side effects that patients feel after starting a new medical treatment. Such symptoms may be the result of the nocebo effect, whereby the expectation of side effects leads to them being experienced. Side effects may also be due to the misattribution of pre-existing or unrelated symptoms to the new medication. Medical professionals' own negative beliefs about a treatment, especially generic drugs, may further enhance patients' expectations of adverse effects. The news media may also influence expectations, particularly when media attention is directed towards a health or medication scare. This field of research has ethical and clinical implications for both medical professionals and the news media with respect to the level and type of information about treatment side effects that is provided to patients or members of the public.

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“…Varelmann and colleagues [9] showed that avoiding negative suggestion and using more reassuring words produced less pain when infiltrating local anaesthetic before neuraxial anaesthesia. Varelmann and colleagues [9] showed that avoiding negative suggestion and using more reassuring words produced less pain when infiltrating local anaesthetic before neuraxial anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

Communications during epidural catheter placement for labour analgesia

Slater¹,

Sellors²,

Cyna

2011

Anaesthesia

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Evidence suggests that anaesthetists' communication can affect patient experience. There is a lack of guidance for anaesthetists as to the optimal verbal communication to use during insertion of epidurals on the labour ward. We recorded the verbal communication used by 14 anaesthetists during the siting of epidural catheters in women on the labour ward; a classification of the language used was subsequently devised. We found that commands and information statements were the most common types of communication used. Individual anaesthetists differed markedly in their use of positive and negative verbal language. This classification of verbal communication that we produced may be of value in future training and research of verbal communication used by anaesthetists on the labour ward.

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Nocebo-induced Hyperalgesia During Local Anesthetic Injection

Cited by 41 publications

References 0 publications

Placebo effects and racial and ethnic health disparities: an unjust and underexplored connection

Placebo effects and racial and ethnic health disparities: an unjust and underexplored connection

The nocebo effect: patient expectations and medication side effects

Communications during epidural catheter placement for labour analgesia

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