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Cited by 442Pain Management and Placebo EffectPain Mechanisms and TreatmentsPain Management and Opioid Use

Response expectancies in placebo analgesia and their clinical relevance

Pollo, Antonella, Amanzio, Martina, Arslanian, Anna, Casadio, Caterina, Maggi, Giuliano, Benedetti, Fabrizio·2001·Pain
DOI 10.1016/s0304-3959(01)00296-2
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Abstract

Response expectancies have been proposed as the major determinant of placebo effects. Here we report that different expectations produce different analgesic effects which in turn can be harnessed in clinical practice. Thoracotomized patients were treated with buprenorphine on request for 3 consecutive days, together with a basal intravenous infusion of saline solution. However, the symbolic meaning of this basal infusion was changed in three different groups of patients. The first group was told nothing about any analgesic effect (natural history). The second group was told that the basal infusion was either a powerful painkiller or a placebo (classic double-blind administration). The third group was told that the basal infusion was a potent painkiller (deceptive administration). Therefore, whereas the analgesic treatment was exactly the same in the three groups, the verbal instructions about the basal infusion differed. The placebo effect of the saline basal infusion was measured by recording the doses of buprenorphine requested over the three-days treatment. We found that the double-blind group showed a reduction of buprenorphine requests compared to the natural history group. However, this reduction was even larger in the deceptive administration group. Overall, after 3 days of placebo infusion, the first group received 11.55 mg of buprenorphine, the second group 9.15 mg, and the third group 7.65 mg. Despite these dose differences, analgesia was the same in the three groups. These results indicate that different verbal instructions about certain and uncertain expectations of analgesia produce different placebo analgesic effects, which in turn trigger a dramatic change of behaviour leading to a significant reduction of opioid intake.

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  • In medical care, placebo and nocebo effects can affect how well a treatment works.

    “In a clinical setting, it has been demonstrated that either or both placebo (positive expectancy of pain relief) and nocebo effects (negative expectancy of increased pain) influence the effectiveness of medical treatment (Kam-Hansen et al., 2014; Pollo et al., 2001).”

    From Distinct neural representations of placebo and nocebo effects (2015) · cites this paper as Pollo et al., 2001

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Authors
Pollo, A., Amanzio, M., Arslanian, A., Casadio, C., Maggi, G., & Benedetti, F.
Affiliations
University of Turin (IT)
Corresponding author
Benedetti, Fabrizio
ORCID
Venue
Pain
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2001-07
Volume
93
Issue
1
Pages
77-84
ISSN
0304-3959 (ISSN-L)
DOI
10.1016/s0304-3959(01)00296-2
OpenAlex
W1987206591
Cited by
442
References
25
Citations by year
2026: 4 · 2025: 11 · 2024: 12 · 2023: 16 · 2022: 11 · 2021: 8 · 2020: 29 · 2019: 16 · 2018: 24 · 2017: 27 · 2016: 17 · 2015: 23 · 2014: 25 · 2013: 20 · 2012: 20
FWCI
6.64
Type
journal article
Language
en
Open access
closed
Locations
  • Pain (publishedVersion)
  • PubMed (publishedVersion)
  • Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
Funders
Centre National de la Recherche Scientifique
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords
placebo analgesia, response expectancy, placebo effect, buprenorphine, thoracotomy, verbal instructions, deception
MeSH terms
Aged, Analgesics, Analgesics, Opioid, Buprenorphine, Double-Blind Method, Female, Humans, Male, Middle Aged, Postoperative Pain, Placebo Effect

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