Long-term opioid use in patients with chronic non-cancer pain (CNCP) can lead to opioid use disorder (OUD) and has been associated with hyperalgesia and reduced quality of life. Studies suggest anti-hyperalgesic properties of buprenorphine, and buprenorphine/naloxone (BuNa) has shown beneficial effects on quality of life in OUD patients without CNCP. This study investigated the added value of BuNa in CNCP patients with OUD on self-reported pain, pain thresholds, pain tolerance, and quality of life (QoL). In the current study, forty-three outpatients with CNCP and OUD were included for inpatient conversion from full μ-receptor agonist opioids to BuNa. Self-reported pain, pain thresholds, pain tolerance, and QoL were determined at baseline and after two months of follow up, using respectively a Visual Analogue Scale (VAS-pain and VAS-QoL), Quantitative Sensory Testing (QST), and Euro-Qol-5-dimensions (EQ-5D). In total 37 participants completed the protocol, and their data were analyzed. The mean VAS-pain score decreased from 51.3 to 37.2 (27.5%, F=3.3; p= 0.044), while the pressure pain threshold and electric pain threshold/tolerance increased after substitution (F=7.8; p=0.005 and F=44.5; p<0.001, respectively), as well as QoL (EQ-5D questionnaire: F=10.4; p=0.003 and VAS-QoL: F=4.4; p=0.043). We found that conversion of full μ-receptor agonists to BuNa, in patients with CNCP with OUD, was accompanied with lower self-reported pain, higher pain thresholds, higher pain tolerance, and improved QoL. Despite several study limitations, these data suggest that BuNa might be of value in CNCP patients with OUD. Future studies should investigate long-term effects of BuNa in randomized trials.

中文翻译：

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阿片类药物轮换对丁丙诺啡/纳洛酮对慢性疼痛和阿片类药物使用障碍患者疼痛、疼痛阈值、疼痛耐受性和生活质量的影响。

慢性非癌性疼痛 (CNCP) 患者长期使用阿片类药物可导致阿片类药物使用障碍 (OUD)，并与痛觉过敏和生活质量下降有关。研究表明丁丙诺啡的抗痛觉过敏特性，丁丙诺啡/纳洛酮 (BuNa) 对没有 CNCP 的 OUD 患者的生活质量显示出有益影响。本研究调查了 BuNa 在患有 OUD 的 CNCP 患者中对自我报告的疼痛、疼痛阈值、疼痛耐受性和生活质量 (QoL) 的附加值。在目前的研究中，43 名 CNCP 和 OUD 门诊患者被纳入从全 μ 受体激动剂阿片类药物到 BuNa 的住院患者转换。在基线和两个月的随访后，分别使用视觉模拟量表（VAS-疼痛和 VAS-QoL）确定自我报告的疼痛、疼痛阈值、疼痛耐受性和生活质量，定量感官测试 (QST) 和 Euro-Qol-5 维度 (EQ-5D)。共有 37 名参与者完成了该协议，并分析了他们的数据。平均 VAS 疼痛评分从 51.3 降至 37.2（27.5%，F=3.3；p=0.044），而替代后压力痛阈和电痛阈/耐受性增加（F=7.8；p=0.005 和 F=44.5 ; p<0.001，分别），以及 QoL（EQ-5D 问卷：F=10.4；p=0.003 和 VAS-QoL：F=4.4；p=0.043）。我们发现，在患有 OUD 的 CNCP 患者中，完全 μ 受体激动剂向 BuNa 的转化伴随着较低的自我报告疼痛、较高的疼痛阈值、较高的疼痛耐受性和改善的生活质量。尽管存在一些研究限制，但这些数据表明 BuNa 可能对患有 OUD 的 CNCP 患者有价值。