Conditioned open-label placebo for opioid reduction after spine surgery: a randomized controlled trial Article Swipe
K. Mikayla Flowers
,
Megan E Patton
,
Valerie Hruschak
,
Kara G. Fields
,
Emily Schwartz
,
Jose Zeballos
,
James D. Kang
,
Rob R. Edwards
,
Ted J. Kaptchuk
,
Kristin L. Schreiber
·
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1097/j.pain.0000000000002185
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1097/j.pain.0000000000002185
Placebo effects have traditionally involved concealment or deception. However, recent evidence suggests that placebo effects can also be elicited when prescribed transparently as “open-label placebos” (OLPs), and that the pairing of an unconditioned stimulus (eg, opioid analgesic) with a conditioned stimulus (eg, placebo pill) can lead to the conditioned stimulus alone reducing pain. In this randomized control trial, we investigated whether combining conditioning with an OLP (COLP) in the immediate postoperative period could reduce daily opioid use and postsurgical pain among patients recovering from spine surgery. Patients were randomized to COLP or treatment as usual, with both groups receiving unrestricted access to a typical opioid-based postoperative analgesic regimen. The generalized estimating equations method was used to assess the treatment effect of COLP on daily opioid consumption and pain during postoperative period from postoperative day (POD) 1 to POD 17. Patients in the COLP group consumed approximately 30% less daily morphine milligram equivalents compared with patients in the treatment as usual group during POD 1 to 17 (−14.5 daily morphine milligram equivalents; 95% CI: [−26.8, −2.2]). Daily worst pain scores were also lower in the COLP group (−1.0 point on the 10-point scale; 95% CI: [−2.0, −0.1]), although a significant difference was not detected in average daily pain between the groups (−0.8 point; 95% CI: [−1.7, 0.2]). These findings suggest that COLP may serve as a potential adjuvant analgesic therapy to decrease opioid consumption in the early postoperative period, without increasing pain.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1097/j.pain.0000000000002185
- OA Status
- green
- Cited By
- 42
- References
- 107
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W3123526701
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W3123526701Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1097/j.pain.0000000000002185Digital Object Identifier
- Title
-
Conditioned open-label placebo for opioid reduction after spine surgery: a randomized controlled trialWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2021Year of publication
- Publication date
-
2021-01-11Full publication date if available
- Authors
-
K. Mikayla Flowers, Megan E Patton, Valerie Hruschak, Kara G. Fields, Emily Schwartz, Jose Zeballos, James D. Kang, Rob R. Edwards, Ted J. Kaptchuk, Kristin L. SchreiberList of authors in order
- Landing page
-
https://doi.org/10.1097/j.pain.0000000000002185Publisher landing page
- Open access
-
YesWhether a free full text is available
- OA status
-
greenOpen access status per OpenAlex
- OA URL
-
https://www.ncbi.nlm.nih.gov/pmc/articles/8378225Direct OA link when available
- Concepts
-
Medicine, Placebo, Analgesic, Anesthesia, Opioid, Randomized controlled trial, Morphine, Surgery, Internal medicine, Pathology, Alternative medicine, ReceptorTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
42Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 11, 2024: 10, 2023: 7, 2022: 9, 2021: 5Per-year citation counts (last 5 years)
- References (count)
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107Number of works referenced by this work
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-
10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.spine | 85 |
| abstract_inverted_index.usual | 160 |
| abstract_inverted_index.worst | 177 |
| abstract_inverted_index.(COLP) | 67 |
| abstract_inverted_index.0.2]). | 216 |
| abstract_inverted_index.access | 101 |
| abstract_inverted_index.assess | 117 |
| abstract_inverted_index.during | 129, 162 |
| abstract_inverted_index.effect | 120 |
| abstract_inverted_index.groups | 98, 210 |
| abstract_inverted_index.method | 113 |
| abstract_inverted_index.opioid | 36, 76, 125, 232 |
| abstract_inverted_index.period | 72, 131 |
| abstract_inverted_index.point; | 212 |
| abstract_inverted_index.recent | 10 |
| abstract_inverted_index.reduce | 74 |
| abstract_inverted_index.scale; | 192 |
| abstract_inverted_index.scores | 179 |
| abstract_inverted_index.trial, | 58 |
| abstract_inverted_index.usual, | 95 |
| abstract_inverted_index.(OLPs), | 26 |
| abstract_inverted_index.(−0.8 | 211 |
| abstract_inverted_index.(−1.0 | 187 |
| abstract_inverted_index.Placebo | 1 |
| abstract_inverted_index.average | 205 |
| abstract_inverted_index.between | 208 |
| abstract_inverted_index.control | 57 |
| abstract_inverted_index.effects | 2, 15 |
| abstract_inverted_index.pairing | 30 |
| abstract_inverted_index.period, | 238 |
| abstract_inverted_index.placebo | 14, 43 |
| abstract_inverted_index.suggest | 219 |
| abstract_inverted_index.therapy | 229 |
| abstract_inverted_index.typical | 104 |
| abstract_inverted_index.whether | 61 |
| abstract_inverted_index.without | 239 |
| abstract_inverted_index.(−14.5 | 167 |
| abstract_inverted_index.10-point | 191 |
| abstract_inverted_index.Abstract | 0 |
| abstract_inverted_index.However, | 9 |
| abstract_inverted_index.Patients | 87, 140 |
| abstract_inverted_index.[−1.7, | 215 |
| abstract_inverted_index.[−2.0, | 195 |
| abstract_inverted_index.adjuvant | 227 |
| abstract_inverted_index.although | 197 |
| abstract_inverted_index.compared | 153 |
| abstract_inverted_index.consumed | 145 |
| abstract_inverted_index.decrease | 231 |
| abstract_inverted_index.detected | 203 |
| abstract_inverted_index.elicited | 19 |
| abstract_inverted_index.evidence | 11 |
| abstract_inverted_index.findings | 218 |
| abstract_inverted_index.involved | 5 |
| abstract_inverted_index.morphine | 150, 169 |
| abstract_inverted_index.patients | 82, 155 |
| abstract_inverted_index.reducing | 52 |
| abstract_inverted_index.regimen. | 108 |
| abstract_inverted_index.stimulus | 34, 41, 50 |
| abstract_inverted_index.suggests | 12 |
| abstract_inverted_index.surgery. | 86 |
| abstract_inverted_index.[−26.8, | 174 |
| abstract_inverted_index.analgesic | 107, 228 |
| abstract_inverted_index.combining | 62 |
| abstract_inverted_index.equations | 112 |
| abstract_inverted_index.immediate | 70 |
| abstract_inverted_index.milligram | 151, 170 |
| abstract_inverted_index.potential | 226 |
| abstract_inverted_index.receiving | 99 |
| abstract_inverted_index.treatment | 93, 119, 158 |
| abstract_inverted_index.−0.1]), | 196 |
| abstract_inverted_index.−2.2]). | 175 |
| abstract_inverted_index.analgesic) | 37 |
| abstract_inverted_index.deception. | 8 |
| abstract_inverted_index.difference | 200 |
| abstract_inverted_index.estimating | 111 |
| abstract_inverted_index.increasing | 240 |
| abstract_inverted_index.prescribed | 21 |
| abstract_inverted_index.randomized | 56, 89 |
| abstract_inverted_index.recovering | 83 |
| abstract_inverted_index.concealment | 6 |
| abstract_inverted_index.conditioned | 40, 49 |
| abstract_inverted_index.consumption | 126, 233 |
| abstract_inverted_index.equivalents | 152 |
| abstract_inverted_index.generalized | 110 |
| abstract_inverted_index.placebos” | 25 |
| abstract_inverted_index.significant | 199 |
| abstract_inverted_index.conditioning | 63 |
| abstract_inverted_index.equivalents; | 171 |
| abstract_inverted_index.investigated | 60 |
| abstract_inverted_index.opioid-based | 105 |
| abstract_inverted_index.postsurgical | 79 |
| abstract_inverted_index.unrestricted | 100 |
| abstract_inverted_index.approximately | 146 |
| abstract_inverted_index.postoperative | 71, 106, 130, 133, 237 |
| abstract_inverted_index.traditionally | 4 |
| abstract_inverted_index.transparently | 22 |
| abstract_inverted_index.unconditioned | 33 |
| abstract_inverted_index.“open-label | 24 |
| cited_by_percentile_year.max | 99 |
| cited_by_percentile_year.min | 97 |
| corresponding_author_ids | https://openalex.org/A5001987274 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 10 |
| corresponding_institution_ids | https://openalex.org/I4210165473 |
| citation_normalized_percentile.value | 0.93963761 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | True |