Background: One contributing factor to the development of nocebo effects is information provided about possible side effects. However, nondisclosure of information can be problematic.
Purpose: We assessed whether positively framed side effect information (highlighting likelihood of not experiencing side effects) can reduce nocebo effects compared to negatively framed information (highlighting likelihood of experiencing side effects).
Methods: One hundred twelve participants took part in research ostensibly assessing the influence of benzodiazepines (actually sham capsules) on anxiety. Participants were randomized to receive a sham capsule with positively or negatively framed information about four side effects, or a no-treatment control condition. Side effect expectations were assessed after information provision. Framed side effects and other unmentioned symptoms were assessed during the session and 24-hr follow-up.
Results: Nocebo effects occurred in symptoms presented as side effects (regardless of framing) during the study session and follow-up (ps < .003). At follow-up, there was also a nocebo effect in other unmentioned symptoms (p = .018). Positive framing reduced side effect symptoms compared with negative framing during the study session (p = .037), but this effect was no longer present at follow-up (p = .53). Side effect expectations did not differ between the framing conditions (p = .14).
Conclusions: Positive framing reduced side effects short-term, but not at follow-up. Expectations did not differ between negative and positive framing. Nocebo effects appeared to generalize to other unmentioned symptoms over a 24-hr period. Further research is needed to determine whether the initial impact of positive framing can be maintained over time.
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http://dx.doi.org/10.1093/abm/kay071 | DOI Listing |
Best Pract Res Clin Anaesthesiol
March 2024
Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, Department of Anesthesia and Critical Care Medicine, 1275 York Avenue, New York, NY, 10028, USA. Electronic address:
The objectives of this minireview are two-fold. The first is to discuss the evolution of opioid analgesia in perioperative medicine in the context of thoracic non-cardiac surgery. Current standard-of-care, aiming to optimize analgesia and limit undesirable side effects, is discussed in the context of multimodal analgesia, specifically enhanced recovery after thoracic surgery pathways.
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March 2024
Department of Anesthesiology, Columbia University, 622 W 168th St, New York, 10032, NY, United States. Electronic address:
Effective pain control is crucial in the management of thoracic surgical patients since it reduces postoperative morbidity and promotes recovery. These patients have co-existing respiratory diseases and impaired pulmonary function, which may be further impaired by surgery. With the adoption of minimally invasive surgical techniques and an emphasis on enhancing recovery after surgery, multimodal analgesia has gained popularity as a way to reduce perioperative opioid use and its associated adverse events such as respiratory depression.
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Department of Cardiology, The First Affiliated Hospital,Hengyang Medical School, University of South China.
Anaemia is a common phenomenon in patients with malignant gynecological tumors. The occurrence of anaemia in the perioperative period leads to an increased probability of blood transfusion, increased surgical complications,poor wound healing, prolonged hospitalization, increased medical costs, and increased mortality. Intravenous iron, which is known for its rapid onset and lack of gastrointestinal side effects, has become increasingly prevalent in clinical practice.
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Yale Medicine/Yale New Haven Health System, USA. Electronic address:
Despite advances in procedural techniques and equipment, postdural puncture headache (PDPH) remains a serious complication of labour epidural analgesia after accidental dural puncture (ADP). Often considered a temporary inconvenience, PDPH can be debilitating in the short term. It can also be associated with chronic manifestations and serious complications.
View Article and Find Full Text PDFBest Pract Res Clin Anaesthesiol
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Department of Anesthesiology, University Hospital Basel, Basel, Switzerland.
The issue of obesity continues to reach new levels globally, affecting individuals across the age continuum. Obesity in pregnancy is associated with myriad comorbidities which may negatively impact the fetus, particularly dysfunctional labor and failure to progress ending in unplanned cesarean delivery. Neuraxial anesthesia represents the gold standard for cesarean delivery anesthesia and is increasingly beneficial for obese patients due to the risk of difficult airway.
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