MPei Cdceaeid* 1/ 00(* 1/08* 1/83fl10/4

cnh9 0/-0/82.ol.omy037
@cuUmbd @bbdrr MtakhbUshnm CUsd9 2/ Itkx 1/08
KohehlWi OdrdWoag :oshaid

BjTrrhrl hm OThm BTpd9 Sgd Pnjd ne OTshdms Rnbhndbnmnlhb RsTstr nm

Mtprdr OThm :rrdrrldms Tmc LTmTfdldms OpTbshbdr
STmhT ApTmcT^n* OgC*) ItbhT BTlonr* LR*y Ihdr cd Ptccdpd* OgC*† Ihdrads Fntadps* OgC*† Tmc

Downloaded from https://academic.oup.com/painmedicine/article/20/11/2094/5540715 by guest on 23 January 2023

RnmhT D, AdpmTpcdr* OgCy
)BHM* CdoUpsUldmsn cd MrhbnknfhU* TmhudprhcUcd @tsnmnlU cd JhranU* JhranU* MnpstfUk: –HPBSD,Hmrshstsn TmhudprhsUphn cd JhranU HPBSD,HTJ(* Bdmspn cd
HmudrshfUb‡^ Un PnbhUk BHP,HTJ(* JhranU* MnpstfUk: †CdoUpsldms ne DwodphldmsUk,BkhmhbUk Umc GdUksg Mrxbgnknfx* Fgdms Tmhudprhsx* Fgdms*
Un d Hmsdpudmb‡^
Adkfhtl

nppdronicdiad sn9 PnmhU E- AdpmUpcdr* MgC* Dche¸bhn HPBSD,HTJ* @u- cUr Enpb‡Ur @plUcUr* 25* BUbhen 23 @@* 0538,/15 Jhranm* MnpstfUk- Sdk9
240,10,68/210/: D,lUhk9 rnmhU-adpmUpcdr;hrbsd,htk-os-

Etmchmf rntpbdr9 Sghr vnpj vUr rtoonpsdc ax sgd EtmcUb‡^

Un oUpU U BhdmbhU d SdbmnknfhU EBS,MnpstfUk: fpUms mtladp9 MSCB.LGB,MPB.1/30.1/03:
MphmbhoUk HmudrshfUsnp9 PnmhU AdpmUpcdr(-

Bnmzhbsr ne hmsdpdrs9 Sgd Utsgnpr cdbkUpd sgUs sgdx gUud mn bnmzhbsr ne hmsdpdrs-

:arspTbs
Naidbshud, PdrdWpbg nm rnbhWk chroWphshdr hm oWhm bWpd gWr addm lWhmkx enbtrdc nm sgd pnkd ne pWbd.pWbhrl Wmc rdw.rdw,
hrl- BkWrrhrl hm oWhm Wrrdrrldms Wmc lWmWfdldms opWbshbdr gWr addm ltbg kdrr hmudrshfWsdc- Vd Whldc sn sdrs sgd
deedbs ne oWshdms rnbhndbnmnlhb rsWstr ’RDR: W opnwx ne rnbhWk bkWrr( nm mtprdr oWhm Wrrdrrldms Wmc lWmWfdldms
opWbshbdr Wmc vgdsgdp oWshdms RDR lnctkWsdc sgd deedbsr ne oWshdms chrspdrr Wmc duhcdmbd ne oWsgnknfx nm rtbg opWb,
shbdr- Cdrhfm, Svn dwodphldmsWk rstchdr vhsg W svn ’oWshdms RDR8 knv.ghfg( ax svn ’oWshdms chrspdrr np duhcdmbd ne oW,
sgnknfx8 Wardms.opdrdms( adsvddm,rtaidbs cdrhfm- Rtaidbsr, EdlWkd mtprdr oWpshbhoWsdc hm svn dwodphldmsWk rstchdr
’M ¼ 02/.M ¼ 025(- Ldsgncr, Mtprdr vdpd opdrdmsdc vhsg W uhfmdssd.ohbstpd cdohbshmf sgd bkhmhbWk bWrd ne W edlWkd vhsg
bgpnmhb knv aWbj oWhm* enkknvdc ax W uhcdn ne sgd oWshdms odpenplhmf W oWhm,hmctbhmf lnudldms- ;esdpvWpcr* mtprdr
pdonpsdc sgdhp oWhm Wrrdrrldms Wmc lWmWfdldms opWbshbdr- Pdrtjsr, Sgd knv,RDR oWshdms r oWhm vWr Wrrdrrdc Wr kdrr
hmsdmrd* lnpd Wssphatsdc sn orxbgnknfhbWk eWbsnpr* Wmc bnmrhcdpdc kdrr bpdchakd ’hm sgd opdrdmbd ne chrspdrr btdr(
sgWm sgd ghfgdp,RDR oWshdms r oWhm- Fhfgdp RDR ateedpdc sgd cdsphldmsWk hloWbs ne sgd opdrdmbd ne chrspdrr btdr nm
oWhm Wrrdrrldms- Mn deedbsr vdpd entmc nm lWmWfdldms opWbshbdr- Bnmbjtrhnmr, Ntp ymchmfr onhms sn sgd onsdmshWk
ateedphmf pnkd ne RDR WfWhmrs sgd cdsphldmsWk deedbs ne bdpsWhm bkhmhbWk btdr nm oWhm Wrrdrrldmsr- Sghr rstcx bnmspha,
tsdr sn ghfgkhfgshmf sgd mddc enp etpsgdp hmudrshfWshnm ne sgd pnkd ne RDR.rnbhWk bkWrr nm oWhm bWpd Wmc hsr tmcdpkxhmf
ldWmhmfr Wmc opnbdrrdr-

Adt Rnocr BkUrrhrl: Pnbhndbnmnlhb PsUstr: MUhm @rrdrrldms Umc LUmUfdldms AhUrdr: ChUfmnrshb Duhcdmbd ne MUsgnknfx: MUshdms
Chrspdrr

Gmspnctbshnm rnbhndbnmnlhb rs]str ’RDR( X5*6[- Sghr o]odq fdmdq]kkx

Qdrd]qbg nm rnbh]k chro]qhshdr hm o]hm b]qd g]r addm
l]hmkx enbtrdc nm sgd qnkd ne q]bd.q]bhrl X0*1[ ]mc rdw.
rdwhrl hm gd]ksg b]qd oqnedrrhnm]kr& ]rrdrrldms ]mc l]m,
]fdldms oq]bshbdr X2fl4[- Bk]rrhrl hm o]hm b]qd* gnvdudq*
g]r addm fhudm ltbg kdrr ]ssdmshnm- Khjd q]bhrl ]mc rdw,
hrl* bk]rrhrl nodq]sdr sgqntfg rnbh]k b]sdfnqhy]shnm ]mc
rsdqdnsxohmf: sg]s hr* hs hlokhdr sgd trd ne rnbh]kkx bnm,
rsqtbsdc ]mc vhcdkx rg]qdc adkhde rxrsdlr ]ants hmchuhct,
]kr nmbd sgdx ]qd b]sdfnqhydc ]bbnqchmf sn sgdhq
bnmsqhatsdr vhsg mnudk dlohqhb]k duhcdmbd nm sgd qnkd ne
o]shdms RDR.bk]rrhrl hm o]hm b]qd-
Duhcdmbd nm sgd deedbsr ne o]shdms RDR.bk]rrhrl hm o]hm
]rrdrrldms ]mc l]m]fdldms hr mns nmkx rb]qbd ats hmbnm,
rhrsdms- Nm sgd nmd g]mc* rnld rstchdr rgnv duhcdmbd ne
bk]rrhrl hm o]hm b]qd- Ogxrhbh]mr g]ud addm rgnvm sn
gnkc mdf]shud ]sshstcdr snv]qc knv,RDR o]shdmsr* vgn
vdqd odqbdhudc ]r cdl]mchmf ]mc kdrr bnlodsdms sn rdke,
l]m]fd o]hm nq enkknv ] ltkshchrbhokhm]qx sqd]sldms X7[-

B 1/08 @ldphbUm @bUcdlx ne MUhm Ldchbhmd- @kk phfgsr pdrdpudc- Enp odplhrrhnmr* okdUrd d,lUhk9 intpmUkr-odplhrrhnmr;nto-bnl 0 42
BiPrrerl em CPem BPod
Ldchb]k rstcdmsr* hm ]m dldqfdmbx ldchbhmd rhltk]shnm*
vdqd kdrr khjdkx sn ]rj ]ants o]hm bnmsqnk ]mc lnqd khjdkx
sn sntbg ] knv,RDR o]shdms X8[- ?krn* knv RDR g]r addm
]rrnbh]sdc vhsg kdrr eqdptdms nohnhc ]mc mnmog]ql]bn,
knfhb]k sqd]sldms oqdrbqhoshnmr* fqd]sdq oqdrbqhoshnm ne
fdmdqhb o]hm ldchb]shnm* ]mc ]m hmbqd]rdc qdbnfmhshnm ne
sgd hlonqs]mbd ne orxbgndctb]shnm X7fl0/[- Nm sgd nsgdq
g]mc* ] rds ne uhfmdssd rstchdr trhmf ] mnudk rnbh]k bk]rr
hlokhbhs ]rrnbh]shnm sdrs chc mns ehmc rhfmhehb]ms deedbsr ne
o]shdms RDR nq ne hlokhbhs bk]rr ah]rdr nm ldchb]k rst,
cdmsr&* mtqrdr&* nq ogxrhbh]mr& o]hm ]rrdrrldms ]mc l]m,
]fdldms cdbhrhnmr X00fl02[- Sgdrd hmbnmrhrsdms ehmchmfr
b]kk enq etqsgdq hmudrshf]shnm ne sgd chqdbs deedbsr ne o],
shdms RDR nm gd]ksg b]qd oqnedrrhnm]kr& ]rrdrrldms ]mc
l]m]fdldms oq]bshbdr- Sghr v]r hmcddc sgd ehqrs ]hl ne
sghr rstcx- ?r mtqrdr ok]x ] ohuns]k qnkd hm o]hm b]qd*
fhudm sgdhq lnqd eqdptdms ]mc bknrdq bnms]bs vhsg
o]shdmsr ]mc sgdhq qnkd ]r hmsdqldch]qhdr adsvddm o]shdmsr
]mc nsgdq ldladqr ne ltkshchrbhokhm]qx sd]lr X03*04[* hs
v]r ntq rodbhehb ]hl sn hmudrshf]sd sgd chqdbs deedbsr ne o],
shdms RDR nm mtqrdr& o]hm ]rrdrrldms ]mc l]m]fdldms
oq]bshbdr-
Ntq rdbnmc ]hl v]r sn hmudrshf]sd vgdsgdq o]shdms
RDR lnctk]sdc sgd deedbsr ne qdkdu]ms bkhmhb]k btdr nm
o]hm ]rrdrrldms ]mc l]m]fdldms oq]bshbdr- ?lnmf ]kk
bnmsdwst]k btdr sg]s l]x hmektdmbd o]hm b]qd* o]shdms chr,
sqdrr¸sg]s hr* rhfmr ne dlnshnm]k.orxbgnknfhb]k rteedqhmf
aqntfgs nm ax o]hm X05[¸]mc ch]fmnrshb duhcdmbd ne o],
sgnknfx¸sg]s hr* bnmehql]shnm* sgqntfg bnlokdldms]qx
ch]fmnrshb sdrsr* ne ] o]sgnknfx nq kdrhnm sg]s hmctbdr
o]hm X06[¸]qd sgd nmdr lnrs rstchdc: o]hm hr nesdm tmcdq,
]rrdrrdc.sqd]sdc hm sgd oqdrdmbd ’ur ]ardmbd( ne o]shdms
chrsqdrr X05* 06[ nq hm sgd ]ardmbd ’ur oqdrdmbd( ne duh,
cdmbd ne o]sgnknfx X05* 06[(- Sgd cdsqhldms]k deedbsr ne
sgdrd u]qh]akdr nm mtqrdr& o]hm ]rrdrrldmsr g]ud addm
entmc hm dwodqhldms]k uhfmdssd,a]rdc rstchdr ’d-f-* X2* 3[(
]mc rstchdr bnmctbsdc hm qd]k bkhmhb]k bnmsdwsr ’d-f-*
X07*08[(- Gnvdudq* hs hr xds tmjmnvm vgdsgdq sgd deedbsr
ne sgnrd bkhmhb]k btdr ]qd hcdmshb]k enq ghfg, ur knv,RDR
o]shdmsr- ? vdkk,cnbtldmsdc ogdmnldmnm hm rnbh]k orx,
bgnknfx rgnvr sg]s odqbdoshnmr ne ldladqr ne knvdqfl
rnbh]k rs]str fqntor ]qd nesdm lnqd cdodmcdms nm bnmsdw,
st]k btdr sg]m odqbdoshnmr ne ldladqr ne ghfgdqflrnbh]k
rs]str fqntor X1/[- Hm nsgdq vnqcr* sghr vntkc rtffdrs
sg]s ghfgdq,RDR o]shdmsr vntkc ad lnqd hlltmd sn sgd
cdsqhldms]k hlo]bs ne bkhmhb]k btdr rtbg ]r sgd oqdrdmbd
ne chrsqdrr nq ]ardmbd ne duhcdmbd ne o]sgnknfx nm sgd
v]x sgdhq o]hm hr ]rrdrrdc ]mc sqd]sdc- Sghr bnmsdmshnm*
gnvdudq* g]r mdudq addm chqdbskx sdrsdc- Sgtr* sghr o]odq
rodbhehb]kkx ]hldc sn sdrs sgd lncdq]shmf deedbsr ne o]shdms
RDR nm sgd hlo]bs ne o]shdms chrsqdrr ]mc ch]fmnrshb duh,
cdmbd ne o]sgnknfx nm mtqrdr& o]hm ]rrdrrldms ]mc l]m,
]fdldms oq]bshbdr-
Sn ]bbnlokhrg sgdrd ]hlr* svn hmcdodmcdms dwodqh,
ldms]k rstchdr vdqd bnmctbsdc hm vghbg o]shdms RDR ]mc
o]shdms chrsqdrr ’rstcx 0( ]mc duhcdmbd ne o]sgnknfx
’rstcx 1( vdqd l]mhotk]sdc sn ]rrdrr sgdhq deedbsr nm
1.84
mtqrdr& o]hm ]rrdrrldms ]mc l]m]fdldms oq]bshbdr- Vd
gxonsgdrhydc sg]s G0( sgd o]hm oqdrdmsdc ax ] knvdq,RDR
o]shdms vntkc ad tmcdq]rrdrrdc.l]m]fdc ]r bnlo]qdc
vhsg sgd o]hm oqdrdmsdc ax ] ghfgdq,RDR o]shdms: G1(
o]hm hm sgd oqdrdmbd ne chrsqdrr.]ardmbd ne duhcdmbd ne o],
sgnknfx vntkc ad tmcdq]rrdrrdc.l]m]fdc ]r bnlo]qdc
vhsg o]hm hm sgd ]ardmbd ne chrsqdrr.oqdrdmbd ne duhcdmbd
ne o]sgnknfx* ]mc sg]s sghr deedbs vntkc ad rsqnmfdq enq
knv,RDR o]shdmsr-
Ldsgncr ’Rstcv 0(
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OWpshbhoWmsr
A]rdc nm ]m ] oqhnqh onvdq ]m]kxrhr enq ] 1 1 e]bsnqh]k
]m]kxrhr ne u]qh]mbd ’?MNU?( bnmctbsdc vhsg F)Onvdq
rnesv]qd ’udqrhnm 2-0-8-1(* sgd cdrhqdc r]lokd rhyd v]r
rds ]s 017* hm nqcdq sn g]ud ] rteehbhdms r]lokd rhyd trhmf
]m ]kog] ne /-/4* ] onvdq ne /-7/* sn cdsdbs ]s kd]rs ld,
chtl deedbs rhydr ’e ¼ /-14( X10[- O]qshbho]msr vdqd
qdbqthsdc uh] sgd Hmsdqmds adsvddm Itmd ]mc Cdbdladq
1/06- Sn bnmsqnk enq bnmentmcr adsvddm mtqrd ]mc o],
shdms rdw* ]mc adb]trd sgdqd hr ] ghfgdq oqdu]kdmbd ne ed,
l]kd o]shdmsr vhsg bgqnmhb o]hm ’BO( X11fl13[* nmkx
edl]kd mtqrdr ]mc mtqrhmf rstcdmsr vdqd hmbktcdc hm sghr
rstcx- Dhfgsx,entq mtqrdr vdqd mns hmbktcdc adb]trd sgdx
chc mns oqnuhcd ]mx rnbhncdlnfq]oghb hmenql]shnm-
Nmd gtmcqdc ehesx Onqstftdrd edl]kd mtqrdr ’72-45 (
]mc mtqrhmf rstcdmsr ’05-33 (* ]fdc 07fl52 ’L ¼ 20-56*
RC ¼ 0/-15( xd]qr* o]qshbho]sdc hm sghr rstcx- Mtqrdr g]c
rdudq]k bkhmhb]k rodbh]kshdr ]mc g]c adsvddm nmd lnmsg
]mc 24 xd]qr ’L ¼ 7-40 xd]qr* RC ¼ 8-88 xd]qr( ne oqnedr,
rhnm]k dwodqhdmbd- ?qntmc 28 ne sgd mtqrdr ’M ¼ 47(
qdonqsdc vnqjhmf nq g]uhmf vnqjdc hm ]m dldqfdmbx cd,
o]qsldms* ]mc 57 ’M ¼ 0/1( vdqd vnqjhmf nq g]c
vnqjdc vhsg o]shdmsr vhsg bgqnmhb o]hm- ?klnrs 27 ne
sgd o]qshbho]msr qdonqsdc rteedqhmf ’M ¼ 25( nq g]uhmf
rteedqdc ’M ¼ 08( bnmrs]ms nq hmsdqlhssdms o]hm enq lnqd
sg]m sgqdd lnmsgr* vhsg ]m ]udq]fd o]hm hmsdmrhsx rbnqd
ne 4-25 nts ne 0/ ’RC ¼ 0-81(- ?cchshnm]kkx* 67
’M ¼ 006( ne sgd o]qshbho]msr qdonqsdc g]uhmf nq g]uhmf
g]c bnms]bs vhsg odnokd rteedqhmf eqnl bgqnmhb o]hm nts,
rhcd ne sgdhq oqnedrrhnm]k bnmsdws-
DwodphldmsWk Cdrhfm
Sghr rstcx bnmrhrsdc ne ] svn ’o]shdms RDR9 knv ur ghfg(
ax svn ’o]shdms chrsqdrr btdr9 ]ardms ur oqdrdms( adsvddm,
rtaidbs cdrhfm- O]qshbho]msr vdqd q]mcnlkx ]rrhfmdc sn
nmd ne sgd entq dwodqhldms]k bnmchshnmr-
Hmcdodmcdms TWphWakdr
Entq vqhssdm uhfmdssdr cdohbshmf ] vghsd edl]kd o]shdms
vhsg bgqnmhb knv a]bj o]hm vdqd trdc sn l]mhotk]sd o],
shdms RDR ]mc chrsqdrr btdr- D]bg o]qshbho]ms v]r rgnvm
nmd ohbstqd ne ] edl]kd o]shdms ]bbnlo]mhdc ax ] vqhssdm
uhfmdssd ]mc nmd uhcdn rdptdmbd ne sg]s o]shdms odqenql,
hmf ] o]hm,hmctbhmf ]bshuhsx ’h-d-* kxhmf cnvm nm ] adc
1.85
]mc rs]mchmf to(- Sgd ohbstqd ]mc sgd uhcdn rdptdmbd
vdqd rdkdbsdc eqnl sgd Fgdms O]hm Uhcdnr ne C]hkx
?bshuhshdr ’F,O?UHC?( X14* 15[- Enq sgd otqonrd ne sghr
rstcx* ] oqdsdrsdc ohbstqd.uhcdn ne ] vnl]m odqbdhudc ]r
lhcckd,]fdc* vhsg mnql]k vdhfgs* cdohbshmf ] lncdq]sd
kdudk ne o]hm adg]uhnq v]r bgnrdm- Oqdsdrsr ]krn rgnvdc
sg]s sghr vnl]m v]r odqbdhudc ]r ]lahftntr hm sdqlr ne
rnbh]k rs]str: sg]s hr* rgd bntkc ad odqbdhudc ]r dhsgdq g]u,
hmf ] knv nq ] lncdq]sd.ghfg RDR* gdmbd ft]q]msddhmf sgd
dbnknfhb]k u]khchsx ne ntq RDR l]mhotk]shnm- O]shdms RDR
v]r l]mhotk]sdc ax kdudk ne dctb]shnm ]mc nbbto]shnm]k
]bshuhsx X16[-
Uhfmdssdr vdqd ]c]osdc eqnl oqduhntr rstchdr bnm,
ctbsdc vhsg mtqrdr X2* 17[- Adknv hr ] r]lokd uhfmdssd*
hmbktchmf sgd ]ksdqm]shud vnqchmf ’hm ankc ]mc o]qdmsgd,
rdr( trdc sn l]mhotk]sd d]bg nmd ne sgd hmcdodmcdms
u]qh]akdr ’hcdmshehdc hm rpt]qd aq]bjdsr( ]mc sgd hmenq,
l]shnm gdkc bnmrs]ms ]bqnrr dwodqhldms]k bnmchshnmr-
Sghr 34,xd]q,nkc vnl]m hr l]qqhdc* bnlokdsdc sgd mhmsg
fqScd ’S cnbsnqSk cdfqdd(* ]mc hr ] eSbsnqx vnqjdq ’itcfd(-
XO]shdms RDR l]mhotk]shnm[- Rgd fndr sn ]m dldqfdmbx
qnnl bnlok]hmhmf ne knv a]bj o]hm* vhsg vghbg rgd
bk]hlr sn g]ud addm khuhmf enq lnqd sg]m entq lnmsgr-
Hm sgd v]hshmf qnnl* sghr vnl]m hr SfhsSsdc Smc Smwhntr
bSkl Smc pthds(- Adrhcdr ] o]hmetk e]bh]k dwoqdrrhnm* sghr
vnl]m hr bnlokShmhmf Smc udqaSkhyhmf gdq oShm eqd)
ptdmskx Smc ronmsSmdntrkx cndr mns bnlokShm nq ronmsS)
mdntrkx udqaSkhyd gdq oShm(- XChrsqdrr btdr l]mhotk]shnm[-
Vgdm b]kkdc sn sqh]fd* sghr vnl]m r]xr rgd g]r addm khu,
hmf vhsg bnmrs]ms ]mc hmsdmrd o]hm hm sgd knvdq a]bj sg]s
q]ch]sdr sn gdq qhfgs kdf- Rgd r]xr sg]s rnldshldr sgd o]hm
hr rn hmsdmrd rgd g]r sqntakd v]kjhmf ]mc rkddohmf* cd,
rbqhahmf hs ]r S eqhfgsdmhmf oShm S rgSqo oShm(- XChrsqdrr
btdr l]mhotk]shnm[-
Sghr vnl]m g]r addm s]jhmf o]q]bds]lnk nm gdq nvm hmh,
sh]shud* cdrohsd mns adhmf ]akd sn fds ]mx qdkhde-
Hm khmd vhsg d]qkhdq rstchdr X2* 17[* entq hmcdodmcdms
mtqrdr bgdbjdc enq sgd bqdchahkhsx* qd]khrl* ]mc qhfnq ne
sgd rbdm]qhnr ’L ]fd ¼ 25-14* RC ¼ 4-01: L xd]qr ne dw,
odqhdmbd ¼ 02-4/* RC ¼ 6-74(-
?esdq rddhmf sgd ohbstqd ]mc qd]chmf sgd uhfmdssd ’ats
adenqd rddhmf sgd uhcdn(* o]qshbho]msr vdqd ]rjdc sn qd,
b]kk rodbhehb cds]hkr ne sgd rbdm]qhn* m]ldkx sgd o]shdms&r
]fd* dctb]shnm* oqnedrrhnm* o]hm ctq]shnm* RDR* ]mc chr,
sqdrr btdr- Odqbdhudc o]shdms RDR v]r ]rrdrrdc vhsg sgd
L]b?qsgtq Rb]kd ne Rtaidbshud Rnbh]k Rs]str X18[- Sghr
rb]kd oqdrdmsr ] zrnbh]k k]ccdq† vhsg 0/ rsdor* ]mc o]q,
shbho]msr vdqd ]rjdc sn ok]bd ]m W nm sgd rsdo nm vghbg
sgdx edks sgd vnl]m rsnnc- ? entq,hsdl rb]kd v]r trdc
sn ld]rtqd o]qshbho]msr& du]kt]shnm ne chrsqdrr btdr
’d-f-* zSn vg]s dwsdms hr sghr vnl]m dwoqdrrhmf ]mw,
hdsx;†: ¼ /-68( X2* 3[- Sgd RDR ]mc chrsqdrr rb]kdr
]kknvdc tr sn ]rrdrr vgdsgdq sgd hmcdodmcdms u]qh]akdr
.oPma^
Pn ds Pi
’o]shdms RDR ]mc chrsqdrr btdr( vdqd rtbbdrretkkx
l]mhotk]sdc-
Cdodmcdms TWphWakdr
MShm 8rrdrrldms
Svn hmcdodmcdms 00,onhms mtldqhb]k q]shmf rb]kdr* q]mf,
hmf eqnl / ’mn o]hm ]s ]kk( sn 0/ ’vnqrs onrrhakd o]hm(*
vdqd trdc sn ]rrdrr o]hm hmsdmrhsx ctqhmf lnudldms ]mc
nudq]kk o]hm hmsdmrhsx- Nmd ne sgd mtldqhb]k q]shmf rb]kdr
v]r trdc hlldch]sdkx ]esdq mtqrdr nardqudc sgd uhcdn ne
sgd o]shdms odqenqlhmf ] o]hm,hmctbhmf ]bshuhsx sn ]rrdrr
Downloaded from https://academic.oup.com/painmedicine/article/20/11/2094/5540715 by guest on 23 January 2023
sgdhq q]shmfr ne o]hm hmsdmrhsx ctqhmf lnudldms ’d-f-*
zGnv cn xnt q]sd sghr vnl]m&r o]hm hmsdmrhsx vghkd rgd
hr odqenqlhmf sghr lnudldms;†(- Sgd nsgdq mtldqhb]k
q]shmf rb]kd v]r trdc sn ]rrdrr mtqrdr& q]shmfr ne sgd nudq,
]kk o]hm hmsdmrhsx fdmdq]kkx edks ax sgd o]shdms ]esdq bnmrhc,
dqhmf ]kk sgd hmenql]shnm oqdrdmsdc hm sgd bkhmhb]k
rbdm]qhn ’d-f-* zBnmrhcdqhmf ]kk sgd hmenql]shnm xnt g]ud
]u]hk]akd ]ants sghr bkhmhb]k b]rd* nudq]kk* gnv cn xnt ]r,
rdrr sghr vnldm&r o]hm hmsdmrhsx;†(- Dkdudm,onhms mtldqh,
b]k q]shmf rb]kdr g]ud addm qdbnlldmcdc ]r nmd ne sgd
lnrs ]ooqnoqh]sd v]xr sn ]rrdrr o]hm hmsdmrhsx X2/[-
Etqsgdqlnqd* a]rdc nm oqduhntrkx u]khc]sdc rb]kdr X2*
17[* sgd enkknvhmf chldmrhnmr ne o]hm itcfldmsr vdqd
]rrdrrdc* d]bg ld]rtqdc vhsg svn hsdlr q]mfhmf eqnl 0
’mns ]s ]kk( sn 6 ’dwsqdldkx(9 o]hm chr]ahkhsx ’d-f-* zSn
vg]s dwsdms cn xnt adkhdud sgd o]hm hmsdqedqdr vhsg sghr
vnl]m&r e]lhkx khed;†: Xra ¼ /-67(* rdudqhsx ne bkhmhb]k
rhst]shnm ’d-f-* zSn vg]s dwsdms cn xnt q]sd sghr o]shdms&r
bkhmhb]k rhst]shnm ]r vnqqxhmf;†: Xra ¼ /-75(* o]hm bqdch,
ahkhsx ’d-f-* zSn vg]s dwsdms cn xnt adkhdud sghr o]shdms&r
o]hm hr fdmthmd;†: Xra ¼ /-8/(* ]mc orxbgnknfhb]k ]ssqhat,
shnmr ’d-f-* zSn vg]s dwsdms cn xnt adkhdud sghr o]shdms&r
o]hm hr b]trdc ax dlnshnm]k e]bsnqr;†: Xra ¼ /-78(-
Rbnqdr vdqd nas]hmdc ax b]kbtk]shmf sgd ]udq]fd ne sgd
svn hsdlr* vhsg ghfgdq rbnqdr qdoqdrdmshmf ghfgdq kdudkr
ne o]hm chr]ahkhsx* fqd]sdq rdudqhsx ne sgd bkhmhb]k rhst]shnm*
fqd]sdq o]hm bqdchahkhsx* ]mc lnqd orxbgnknfhb]k
]ssqhatshnmr-
MShm ISmSfdldms
? oqduhntrkx u]khc]sdc ld]rtqd X20[ v]r trdc sn q]sd
mtqrdr& vhkkhmfmdrr sn needq rtoonqs sn sgd o]hm o]shdms-
Entq hsdlr ld]rtqdc mtqrdr& vhkkhmfmdrr sn needq hmrsqt,
ldms]k rtoonqs ’d-f-* zSn vg]s dwsdms vntkc xnt ad vhkk,
hmf sn gdko sghr vnl]m ok]bd gdqrdke hm ] onrhshnm sn
qdkhdud gdq o]hm;†(* ]mc entq hsdlr ld]rtqdc mtqrdr& vhkk,
hmfmdrr sn needq dlnshnm]k rtoonqs ’d-f-* zSn vg]s dwsdms
vntkc xnt ad vhkkhmf sn s]kj vhsg sghr vnl]m sn aqhmf
gdq rnld dlnshnm]k bnlenqs;†(- ?kk hsdlr vdqd q]sdc nm
] Khjdqs,sxod rb]kd q]mfhmf eqnl 0 ’mns ]s ]kk vhkkhmf( sn 6
’dwsqdldkx vhkkhmf(- Bqnma]bg&r ]kog] v]r /-67 enq hm,
rsqtldms]k rtoonqs ]mc /-80 enq dlnshnm]k rtoonqs* hmch,
b]shmf fnnc hmsdqm]k bnmrhrsdmbx- Rbnqdr enq d]bg
chldmrhnm vdqd nas]hmdc ax b]kbtk]shmf sgd ]udq]fd ne
sgd entq hsdlr* vhsg ghfgdq rbnqdr qdoqdrdmshmf ghfgdq
BiPrrerl em CPem BPod 1.86

kdudkr ne vhkkhmfmdrr sn needq hmrsqtldms]k nq dlnshnm]k jmnvhmf lnqd ]ants sgd rstcx rtalhssdc sgdhq d,l]hk
rtoonqs- ]ccqdrrdr-
?cchshnm]kkx* cq]vhmf tonm sgd L]mbgdrsdq Sqh]fd
rxrsdl enq dldqfdmbx cdo]qsldmsr X21[* sgd enkknvhmf
CWsW ;mWkxrhr
ptdrshnm v]r ]rjdc ’zHl]fhmd sg]s xnt vhkk g]ud sn ]s,
?kk ]m]kxrdr vdqd odqenqldc trhmf RORR* udqrhnm 12-/
sqhatsd nmd ne sgd enkknvhmf bnknqr sn sgd o]shdms* bnmrhc,
’RORR* Hmb-* Bghb]fn* HK* TR?(- Cdrbqhoshud rs]shrshbr vdqd
dqhmf sg]s xntq bgnhbd vhkk cdsdqlhmd sgd l]whltl shld
trdc sn cdrbqhad o]qshbho]msr& rnbhncdlnfq]oghb ]mc bkhm,
sg]s rgd vhkk g]ud sn v]hs sn ad rddm sgd ldchb]k sd]l ne
hb]k c]s] ]mc rtll]qhyd o]qshbho]msr& qdronmrdr-
sgd dldqfdmbx cdo]qsldms- Okd]rd* bgnnrd sgd bnknq sg]s
Hmcdodmcdms,r]lokdr r sdrsr vdqd trdc sn bgdbj sgd l],
xnt hmsdmc sn ]ssqhatsd sn sghr o]shdms-†( vhsg ] ehud,onhms
mhotk]shnm ne hmcdodmcdms u]qh]akdr ’h-d-* RDR ]mc chrsqdrr
rb]kd* qdoqdrdmsdc ax ehud bnknqr ]r enkknvr9 0 ¼ aktd9 mnm,
btdr(- O]qshbho]msr vgn vdqd mns ]akd sn bnqqdbskx qdb]kk

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tqfdms ’h-d-* 13/ lhmtsdr& l]whltl v]hshmf shld(:
sgd o]shdms&r dctb]shnm* oqnedrrhnm* o]hm ctq]shnm* ]mc
1 ¼ fqddm9 rs]mc]qc ’h-d-* 01/ lhmtsdr& l]whltl v]hshmf
RDR vdqd dwbktcdc eqnl sgd ]m]kxrdr- Od]qrnm ’X( ]mc
shld(: 2 ¼ xdkknv9 tqfdms ’h-d-* 5/ lhmtsdr& l]whltl
Rod]ql]m ’Xr( bnqqdk]shnmr ]mc r sdrsr vdqd bnmctbsdc sn
v]hshmf shld(: 3 ¼ nq]mfd9 udqx tqfdms ’h-d-* 0/ lhmtsdr&
dwoknqd sgd ]rrnbh]shnmr adsvddm rnbhncdlnfq]oghb ’d-f-*
l]whltl v]hshmf shld(: 4 ¼ qdc9 hlldch]sd ’h-d-*
]fd* xd]qr ne oqnedrrhnm]k dwodqhdmbd* oqnedrrhnm]k ur rst,
/ lhmtsdr& l]whltl v]hshmf shld(- Sgd ghfgdq sgd rbnqd*
cdms rs]str( ]mc bkhmhb]k bg]q]bsdqhrshbr ’d-f-* odqrnm]k
sgd knvdq sgd v]hshmf shld* gdmbd* sgd ghfgdq sgd
]mc uhb]qhntr o]hm dwodqhdmbdr( ]mc o]hm ]rrdrrldms ]mc
dldqfdmbx-
l]m]fdldms u]qh]akdr- Nmkx ]fd ]mc xd]qr ne oqnedr,
rhnm]k dwodqhdmbd vdqd rhfmhehb]mskx bnqqdk]sdc vhsg orx,
bgnknfhb]k ]ssqhatshnmr ’X’017( ¼ /-12* F /-/4* ]mc X’017(
Opnbdctpd
¼ /-11* F /-/4* qdrodbshudkx(- Sgd r]ld o]ssdqm v]r
Sghr rstcx v]r ]ooqnudc ax sgd Dsghb]k Bnllhssdd ne sgd
nardqudc vhsg sgd L]mbgdrsdq Sqh]fd u]qh]akd ’Xr’017( ¼
HRBSDflKhranm Tmhudqrhsx Hmrshstsd ’Qdedqdmbd9 01.1/06(-
/-13* F /-/4* enq ]fd ]mc Xr’017( ¼ /-18* F /-/0* enq
C]s] vdqd bnkkdbsdc trhmf sgd nmkhmd rnesv]qd oqnfq]l
xd]qr ne oqnedrrhnm]k dwodqhdmbd(- Adb]trd ]fd ]mc xd]qr
Pt]ksqhbr- Cheedqdms mtqrhmf rbgnnkr vdqd bnms]bsdc ]mc
ne oqnedrrhnm]k dwodqhdmbd vdqd ghfgkx bnqqdk]sdc ’X’017(
]rjdc sn rdmc ] qdbqthsldms d,l]hk sn sgdhq onrsfq]ct]sd
¼ /-84* F /-/0(* vd cdbhcdc sn trd nmkx ]fd ]r ] bnu]qh,
rstcdms l]hkhmf khrsr hmuhshmf sgdl sn o]qshbho]sd hm sgd
]sd hm sgd ]m]kxrdr qdf]qchmf orxbgnknfhb]k ]ssqhatshnmr
rstcx- ?cchshnm]kkx* svn otakhb gnrohs]kr hm Khranm vdqd
]mc L]mbgdrsdq Sqh]fd-
bnms]bsdc hm nqcdq sn rg]qd sgd nmkhmd ptdrshnmm]hqd
Bnqqdk]shnmr ]lnmf sgd cdodmcdms u]qh]akdr vdqd ]krn
]lnmf sgdhq mtqrhmf rs]ee- Sgd rstcx v]r ]ooqnudc ax
]m]kxydc- Rhfmhehb]ms bnqqdk]shnmr vdqd entmc adsvddm
sgd an]qcr ne chqdbsnqr ]mc.nq dsghb]k bnllhssddr ne sgd
o]hm hmsdmrhsx ctqhmf lnudldms ]mc nudq]kk o]hm hmsdm,
o]qshbho]shmf hmrshstshnmr- Sgd ]hlr ne sgd rstcx vdqd cd,
rhsx ’X’017( ¼ /-77* F /-/0(* adsvddm o]hm chr]ahkhsx ]mc
rbqhadc nm sgd gnld o]fd- O]qshbho]msr vdqd hmuhsdc sn
rdudqhsx ne sgd bkhmhb]k rhst]shnm ’X’017( ¼ /-61* F /-/0(*
s]jd o]qs hm ] rstcx rtoonrdckx nm ldlnqx ]mc cdbhrhnm,
]mc adsvddm hmrsqtldms]k rtoonqs ]mc dlnshnm]k rto,
l]jhmf oqnbdrrdr hm bkhmhb]k bnmsdwsr- O]qshbho]msr vdqd
onqs ’X’013( ¼ /-51* F /-/0(- Fhudm sgdrd qdrtksr* sgqdd
snkc sg]s sgd rstcx ]hldc sn tmcdqrs]mc gnv ldlnqx
ltkshu]qh]sd ]m]kxrdr ne u]qh]mbd ’L?MNU?r( vdqd bnm,
]mc cdbhrhnm,l]jhmf oqnbdrrdr vntkc hmektdmbd gd]ksg
ctbsdc enq ]m]kxyhmf sgd l]hm ]mc hmsdq]bshnm deedbsr ne
b]qd oqnedrrhnm]kr& itcfldmsr vgdm e]bhmf ] bkhmhb]k rbd,
RDR ]mc chrsqdrr nm sgdrd sgqdd rdsr ne u]qh]akdr- ? svn,
m]qhn- Hmenqldc bnmrdms v]r qdpthqdc sn oqnbddc sn sgd
v]x ?MNU? v]r bnmctbsdc nm o]hm bqdchahkhsx- Svn
rtqudx- O]qshbho]msr vdqd q]mcnlkx ]kknb]sdc sn nmd ne
svn,v]x ]m]kxrhr ne bnu]qh]mbd ’?MBNU?( vdqd bnm,
sgd entq dwodqhldms]k bnmchshnmr- Ehqrs* o]qshbho]msr r]v
ctbsdc nm orxbgnknfhb]k ]ssqhatshnmr ]mc sgd L]mbgdrsdq
sgd ohbstqd ]mc qd]c sgd ]rrnbh]sdc uhfmdssd- Sgdm* sgdx
Sqh]fd rbnqd* qdrodbshudkx* bnmsqnkkhmf enq ]fd- Onrs gnb
vdqd ]rjdc sn qdb]kk rdudq]k cds]hkr ne sgd bkhmhb]k rbdm]qhn
rhlokd deedbs ]m]kxrdr vdqd trdc sn cdbnlonrd sgd rhfmheh,
hm nqcdq sn bgdbj sgd l]mhotk]shnmr ne sgd hmcdodmcdms
b]ms hmsdq]bshnm deedbsr- ? rhfmhehb]mbd kdudk ne /-/4 v]r
u]qh]akdr- Rtardptdmskx* o]qshbho]msr r]v sgd uhcdn ]mc
]rrtldc enq ]kk ]m]kxrdr-
vdqd ]rjdc sn ]rrdrr sgd o]shdms&r o]hm ]mc qdonqs sgdhq
hmsdmshnmr sn gdko sgd o]shdms- Ehm]kkx* rnbhncdlnfq]oghb
]mc bkhmhb]k c]s] vdqd bnkkdbsdc* sg]s hr* ]fd* dctb]shnm*
vnqjok]bd* xd]qr ne oqnedrrhnm]k dwodqhdmbd* oqduhntr
Pdrtjsr
oqnedrrhnm]k dwodqhdmbd hm ]m dldqfdmbx cdo]qsldms* ]mc LWmhotkWshnm Bgdbj
odqrnm]k ]mc uhb]qhntr dwodqhdmbd vhsg BO- Ne sgd 04/ o]qshbho]msr* 11 vdqd dwbktcdc eqnl sgd ]m]k,
Sgd shld qdpthqdc sn bnlokdsd sgd oqnsnbnk v]r nm ]u, xrdr adb]trd sgdx e]hkdc sgd l]mhotk]shnm bgdbjr-
dq]fd 00 lhmtsdr- Nmd 14 fhes untbgdq v]r cq]vm ]s Rodbhehb]kkx* 0/ o]qshbho]msr vdqd dwbktcdc adb]trd sgdx
q]mcnl ]lnmf sgnrd vgn kdes sgdhq d,l]hkr ]r bnlodmr], qdb]kkdc sgd o]shdms&r o]hm ]r ]btsd ’o]hm edks enq kdrr sg]m
shnm enq o]qshbho]shnm- ?krn* o]qshbho]msr vdqd sg]mjdc entq gntqr nq entq c]xr(* ]mc 01 e]hkdc sn odqbdhud sgd
]mc cdaqhdedc* ]mc sgd nmdr vgn vdqd hmsdqdrsdc hm o]shdms&r RDR ]r knv nq ghfg ]bbnqchmf sn sgd rbdm]qhn
1.87 .oPma^
Pn ds Pi

STajd 0, LWhm Wmc hmsdpWbshnm tmhuWphWsd deedbsr ne oWshdms rnbhndbnmnlhb rsWstr Wmc chrspdrr btdr nm oWhm Wrrdrrldms Wmc
lWmWfdldms opWbshbdr ’Rstcx 0(

RDR Chrsqdrr RDR)Chrsqdrr

L ’RC( L ’RC(

Knv Ghfg 2 ?ardms Oqdrdms E E

O]hm ]rrdrrldms
O]hm hmsdmrhsx nm lnudldms 4-08 ’0-74( 4-71 ’0-67( 2-64z .-.2 4-52 ’0-81( 4-23 ’0-64( /-70 /-/0 /-1/ /-//
Nudq]kk o]hm hmsdmrhsx 4-38 ’0-7/( 5-11 ’0-56( 4-50) .-.3 4-73 ’0-8/( 4-70 ’0-52( /-/1 /-// /-56 /-/0
O]hm chr]ahkhsx 4-/0 ’/-77( 4-/2 ’/-75( /-/0 /-// 3-88 ’/-76( 4-/4 ’/-76( /-06 /-// /-/4 /-//
Rdudqhsx ne bkhmhb]k rhst]shnm 3-18 ’/-75( 3-21 ’/-53( /-/4 /-// 3-15 ’/-70( 3-23 ’/-60( /-30 /-// /-/0 /-//
O]hm bqdchahkhsx 3-88 ’/-86( 4-15 ’/-83( 1-41 /-/1 4-10 ’/-85( 4-/1 ’/-85( 0/-// /-/0 2-5.z .-.2

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Orxbgnknfhb]k ]ssqhatshnmr 2-43 ’0-/8( 2-/4 ’0-0/( 5-77)) .-.4 2-/1 ’0-03( 2-48 ’0-/1( 6-55)) .-.5 /-// /-//
O]hm l]m]fdldms
Hmrsqtldms]k rtoonqs 4-04 ’/-88( 4-32 ’/-77( 1-60 /-/1 4-24 ’/-80( 4-10 ’0-//( /-58 /-// /-37 /-//
Dlnshnm]k rtoonqs 4-32 ’0-01( 4-46 ’0-//( /-36 /-// 4-32 ’0-00( 4-45 ’0-/1( /-53 /-/0 1-24 /-/1

RDR ¼ rnbhndbnmnlhb rs]str- Rhfmh“b]ms qdrtksr ]qd oqdrdmsdc hm ankc-

)F /-/4: ))F " /-/0: )))F " /-//0-–/-/5-

oqdrdmsdc- Sgtr* 017 o]qshbho]msr vdqd hmbktcdc hm sgd
]m]kxrdr- Mn rnbhncdlnfq]oghb cheedqdmbdr vdqd entmc
adsvddm hmbktcdc ]mc dwbktcdc o]qshbho]msr a]rdc nm sgd
RDR l]mhotk]shnm bgdbj-
?m]kxrdr rgnvdc sg]s sgd l]mhotk]shnmr vnqjdc9
Rhfmhehb]ms cheedqdmbdr vdqd entmc adsvddm sgd svn bnm,
chshnmr hm odqbdhudc RDR ’r’015( ¼ fl13-67* F /-/0:
LKnvRDR ¼ 2-83* RC ¼ /-83: ur LGhfgRDR ¼ 7-12* RC ¼
0-/0( ]mc o]shdms chrsqdrr odqbdoshnmr ’r’013( ¼ fl04-02* F
/-/0: L]ardms ¼ 1-30* RC ¼ /-67: ur Loqdrdms ¼ 3-34*
RC ¼ /-62(-
RDR LWhm Deedbsr nm OWhm ;rrdrrldms Wmc
LWmWfdldms OpWbshbdr
? anqcdqkhmd ltkshu]qh]sd l]hm deedbs ne o]shdms RDR nm
o]hm hmsdmrhsx q]shmfr v]r entmc ’2 ’1* 012( ¼ 1-72*
F ¼ /-/5* ds]1 ¼/-/3(: tmhu]qh]sd sdrsr ’S]akd 0( rgnvdc
] rhfmhehb]ms l]hm deedbs ne o]shdms RDR nm drshl]sdc nudq,
]kk o]hm hmsdmrhsx ]mc ] l]qfhm]kkx rhfmhehb]ms deedbs ne o],
shdms RDR nm drshl]sdc o]hm hmsdmrhsx ctqhmf lnudldms-
Nudq]kk* sgd ghfgdq,RDR o]shdms v]r odqbdhudc ]r g]uhmf
lnqd hmsdmrd o]hm sg]m sgd knvdq,RDR o]shdms- ? l]hm de,
edbs ne o]shdms RDR nm orxbgnknfhb]k ]ssqhatshnmr v]r ]krn
entmc- Sgd knvdq,RDR o]shdms&r o]hm v]r ]ssqhatsdc sn
orxbgnknfhb]k e]bsnqr sn ] fqd]sdq cdfqdd sg]m sgd ghfgdq,
RDR o]shdms&r o]hm-
O]shdms RDR v]r mns entmc sn g]ud rhfmhehb]ms l]hm
deedbsr nm sgd mtqrdr& itcfldmsr ne o]hm chr]ahkhsx* sgd rd,
udqhsx ne sgd bkhmhb]k rhst]shnm* nq bqdchahkhsx* nq nm sgdhq
hmsdmshnmr ne needqhmf rtoonqs sn sgd o]shdms ]mc ]ssqhat,
shnm ne v]hshmf shld ’L]mbgdrsdq Sqh]fd(-
LWhm Deedbsr ne OWshdms Chrspdrr Btdr nm OWhm
;rrdrrldms Wmc LWmWfdldms OpWbshbdr
Qdrtksr rgnvdc ] rhfmhehb]ms l]hm deedbs ne o]shdms chr,
sqdrr btdr nm orxbgnknfhb]k ]ssqhatshnmr ’S]akd 0(* vhsg
mtqrdr ]ssqhatshmf lnqd orxbgnknfhb]k e]bsnqr sn o]hm
vgdm hm sgd oqdrdmbd ne chrsqdrr btdr sg]m vgdm rtbg btdr
vdqd ]ardms- Mn rhfmhehb]ms l]hm deedbsr vdqd entmc ne
o]shdms chrsqdrr btdr nm mtqrdr& itcfldmsr ne o]hm hmsdm,
rhsx* chr]ahkhsx* rdudqhsx ne sgd bkhmhb]k rhst]shnm* nq bqdch,
ahkhsx* mnq nm sgdhq hmsdmshnmr ne needqhmf rtoonqs sn sgd
o]shdms ]mc ]ssqhatshnm ne v]hshmf shld ’L]mbgdrsdq
Sqh]fd(-
HmsdpWbshnm Deedbsr Adsvddm RDR Wmc OWshdms
Chrspdrr Btdr nm OWhm ;rrdrrldms Wmc
LWmWfdldms OpWbshbdr
? l]qfhm]k hmsdq]bshnm deedbs ne o]shdms RDR ]mc chrsqdrr
btdr v]r entmc enq o]hm bqdchahkhsx ’S]akd 0(- Ehftqd 0
cdohbsr sgd rhlokd deedbs ]m]kxrhr- Sgd knv,RDR o]shdms&r
o]hm v]r odqbdhudc ]r kdrr bqdchakd sg]m sgd ghfg,RDR
o]shdms&r o]hm* ats nmkx vgdm chrsqdrr btdr vdqd oqdrdms-
?krn* o]hm hm sgd oqdrdmbd ne chrsqdrr btdr v]r itcfdc ]r
kdrr bqdchakd sg]m hm sgd ]ardmbd ne chrsqdrr btdr* ats nmkx
enq sgd knv,RDR o]shdms-
Bnmbjtrhnmr
Ntq ehmchmfr rgnv sg]s o]shdms RDR hmektdmbdc rnld ne
sgd mtqrdr& o]hm ]rrdrrldmsr ats mns sgdhq l]m]fdldms
oq]bshbdr- Qdrtksr o]qsh]kkx bnmehqldc ntq gxonsgdrhr 0*
rgnvhmf sg]s mtqrdr rkhfgskx tmcdqdrshl]sdc sgd knv,RDR
o]shdms&r o]hm ]r bnlo]qdc vhsg sgd ghfg,RDR o]shdms&r
o]hm: lnqd rodbhehb]kkx* sgd enqldq v]r odqbdhudc ]r eddk,
hmf kdrr hmsdmrd o]hm sg]m sgd k]ssdq* ]mc gdq o]hm v]r
lnqd ]ssqhatsdc sn orxbgnknfhb]k e]bsnqr- Etqsgdqlnqd* ]r
dwodbsdc* ]mc hm khmd vhsg oqduhntr rstchdr X3* 05* 06[*
sgd oqdrdmbd ne chrsqdrr btdr kd]cr sn lnqd orxbgnknfhb]k
]ssqhatshnmr sn o]hm sg]m sgd ]ardmbd ne chrsqdrr btdr- Ntq
gxonsgdrhr 1 v]r ]krn o]qsh]kkx bnmehqldc: o]hm hm sgd
oqdrdmbd ne chrsqdrr btdr v]r odqbdhudc ]r kdrr bqdchakd
sg]m o]hm hm sgd ]ardmbd ne chrsqdrr btdr* ats nmkx enq
knv,RDR o]shdmsr- Lnqdnudq* hs v]r nmkx hm sgd oqdrdmbd
BiPrrerl em CPem BPod
6
))
5
4,13
4 3,64
OShm bpdchahihsw
3
0
.
Hnv PDP
9hrspdrr Sardms
Dhftpd 0, HmsdpWbshnm deedbs adsvddm oWshdms rnbhndbnmnlhb rsWstr Wmc chrspdrr btdr nm oWhm bpdchahkhsx ’Rstcx 0(- )C
/-/0: )))C " /-//0-
ne chrsqdrr btdr sg]s sgd knv,RDR o]shdms&r o]hm v]r odq,
bdhudc ]r kdrr bqdchakd sg]m sgd ghfg,RDR o]shdms&r o]hm-
Ldsgncr ’Rstcv 1(
OWpshbhoWmsr
Trhmf ]m hcdmshb]k qdbqthsldms oqnbdctqd ]r hm Rstcx 0*
160 mdv hmchuhct]kr o]qshbho]sdc hm Rstcx 1- Dhfgsx,entq
o]qshbho]msr vdqd dwbktcdc ]r sgdx chc mns oqnuhcd ]mx
rnbhncdlnfq]oghb hmenql]shnm* qdrtkshmf hm ] ehm]k r]l,
okd ne 047 Onqstftdrd edl]kd mtqrdr ’54 ( ]mc mtqrhmf
rstcdmsr ’24 (* ]fdc 07fl53 ’L ¼ 17-32* RC ¼ 0/-6/(
xd]qr- Mtqrdr g]c rdudq]k bkhmhb]k rodbh]kshdr ]mc g]c ad,
svddm nmd lnmsg ]mc 31 xd]qr ’L ¼ 0/-6/ xd]qr* RC ¼
0/-45 xd]qr( ne oqnedrrhnm]k dwodqhdmbd- ?qntmc 20 ne
sgd mtqrdr ’M ¼ 38( qdonqsdc vnqjhmf nq g]uhmf vnqjdc
hm ]m dldqfdmbx cdo]qsldms* ]mc 45 ’M ¼ 77( qdonqsdc
vnqjhmf nq g]uhmf vnqjdc vhsg o]shdmsr vhsg bgqnmhb
o]hm- ?klnrs 24 ne sgd o]qshbho]msr qdonqsdc rteedqhmf
’M ¼ 22( nq g]uhmf rteedqdc ’M ¼ 10( bnmrs]ms nq hmsdq,
lhssdms o]hm enq lnqd sg]m sgqdd lnmsgr* vhsg ]m ]udq]fd
o]hm hmsdmrhsx rbnqd ne 4-4 nts ne 0/ ’RC ¼ 0-65(-
?cchshnm]kkx* 72 ne sgd o]qshbho]msr qdonqsdc g]uhmf nq
g]uhmf g]c bnms]bs vhsg odnokd rteedqhmf eqnl bgqnmhb
o]hm ntsrhcd ne sgdhq oqnedrrhnm]k bnmsdws-
DwodphldmsWk Cdrhfm
Sghr rstcx bnmrhrsdc ne ] svn ’o]shdms RDR9 knv ur ghfg(
ax svn ’duhcdmbd ne o]sgnknfx9 ]ardms ur oqdrdms(
adsvddm,rtaidbsr cdrhfm- O]qshbho]msr vdqd q]mcnlkx
]rrhfmdc sn nmd ne sgd entq dwodqhldms]k bnmchshnmr-
Hmcdodmcdms TWphWakdr
Sgd oqnbdctqdr trdc sn l]mhotk]sd sgd hmcdodmcdms u]qh,
]akdr vdqd rhlhk]q sn sgd oqnbdctqdr cdrbqhadc hm Rstcx 0-
Adknv hr ] r]lokd uhfmdssd* hmbktchmf sgd ]ksdqm]shud
1.88
))
4,07 4,22
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Eheg PDP
9hrspdrr opdrdms
/-/2: ))C "
vnqchmf ’hm ankc ]mc o]qdmsgdrdr( trdc sn l]mhotk]sd
d]bg nmd ne sgd hmcdodmcdms u]qh]akdr ’hcdmshehdc hm
rpt]qd aq]bjdsr( ]mc sgd hmenql]shnm gdkc bnmrs]ms
]bqnrr dwodqhldms]k bnmchshnmr-
Sghr 34,xd]q,nkc vnl]m hr l]qqhdc* bnlokdsdc sgd mhmsg
fqScd ’S cnbsnqSk cdfqdd( ]mc hr ] eSbsnqx vnqjdq ’itcfd(-
XO]shdms RDR l]mhotk]shnm[- Rgd fndr sn ]m dldqfdmbx
qnnl bnlok]hmhmf ne knv a]bj o]hm* vhsg vghbg rgd
bk]hlr sn g]ud addm khuhmf enq lnqd sg]m entq lnmsgr-
Sghr vnl]m r]xr sg]s rgd g]r addm khuhmf vhsg ] bnmrs]ms
]mc hmsdmrd knv a]bj o]hm q]ch]shmf sn gdq qhfgs knvdq khla-
Rgd r]xr sg]s rnldshldr sgd o]hm hr rn hmsdmrd sg]s rgd g]r
sqntakd v]kjhmf ]mc rkddohmf- Rgd g]r addm s]jhmf o]q]bds],
lnk nm gdq nvm hmhsh]shud enq o]hm qdkhde vhsgnts rtbbdrr-
Qdbdmskx* sghr vnl]m g]c ]m w,q]x* bnlotsdc snlnfq],
ogx ’B?S( rb]m* ]mc l]fmdshb qdrnm]mbd hl]fhmf ’LQH(
ne sgd ktla]q rohmd sg]s rgnvdc rhfmhehbSms duhcdmbd ne S
gdqmhSsdc chrb chc mns rgnv Smx duhcdmbd ne rhfmhehbSms
SmnlSkhdr(- XDuhcdmbd ne o]sgnknfx l]mhotk]shnm[-
?r hm Rstcx 0* o]qshbho]msr vdqd ]rjdc sn qdb]kk hmenql],
shnm ]ants sgd o]shdms&r ]fd* dctb]shnm* oqnedrrhnm* o]hm
ctq]shnm* RDR* ]mc oqdrdmbd ne duhcdmbd ne o]sgnknfx ]r ]
l]mhotk]shnm bgdbj- ?r hm sgd oqduhntr rstcx* odqbdo,
shnmr ne o]shdms RDR vdqd ]rrdrrdc vhsg sgd L]b?qsgtq
Rb]kd ne Rtaidbshud Rnbh]k Rs]str- Sn qdb]kk sgd oqdrdmbd
nq ]ardmbd ne duhcdmbd ne o]sgnknfx* o]qshbho]msr vdqd
]rjdc vgdsgdq sgd ch]fmnrshb sdrs qdrtksr ’h-d-* w,q]x* B?S
rb]m* ]mc LQH( rgnvdc.chc mns rgnv duhcdmbd ne rhfmheh,
b]ms ]mnl]khdr ne ] gdqmh]sdc chrb ’xdr nq mn(-
Cdodmcdms TWphWakdr
Cdodmcdms u]qh]akdr vdqd sgd r]ld ]r hm Rstcx 0- Enq o]hm
]rrdrrldms ld]rtqdr* sgd Rod]ql]m,Aqnvm bndeehbhdms v]r
10..
/-63 enq o]hm chr]ahkhsx* /-67 enq rdudqhsx ne sgd bkhmhb]k rhs,
t]shnm* /-61 enq o]hm bqdchahkhsx* ]mc /-75 enq orxbgnknfh,
b]k ]ssqhatshnmr* hmchb]shmf fnnc hmsdqm]k bnmrhrsdmbx enq
]kk chldmrhnmr- Enq o]hm l]m]fdldms ld]rtqdr*
Bqnma]bg&r ]kog] v]r /-7/ enq hmrsqtldms]k rtoonqs ]mc
/-72 enq dlnshnm]k rtoonqs* hmchb]shmf fnnc hmsdqm]k
bnmrhrsdmbx-
Opnbdctpd
Sgd oqnbdctqd v]r hcdmshb]k sn sg]s ne Rstcx 0-
CWsW ;mWkxrdr
C]s] ]m]kxrhr oqnbdctqdr vdqd rhlhk]q sn sgd nmdr cd,
rbqhadc hm Rstcx 0- Mn rhfmhehb]ms ]rrnbh]shnmr vdqd
entmc adsvddm rnbhncdlnfq]oghb.bkhmhb]k ]mc cdodmcdms
u]qh]akdr- ?r hm sgd oqduhntr rstcx* rhfmhehb]ms bnqqdk],
shnmr vdqd entmc adsvddm o]hm hmsdmrhsx ctqhmf lnud,
ldms ]mc nudq]kk o]hm hmsdmrhsx ’X’013( ¼ /-78* F
/-//0(* adsvddm o]hm hmsdqedqdmbd ]mc rdudqhsx ne sgd bkhm,
hb]k rhst]shnm ’X’013( ¼ /-58* F /-//0(* ]mc adsvddm
hmsdmshnmr ne oqnuhchmf hmrsqtldms]k rtoonqs ]mc dln,
shnm]k rtoonqs ’X’013( ¼ /-44* F /-//0(- Fhudm sgdrd
qdrtksr* sgqdd L?MNU?r vdqd bnmctbsdc enq ]m]kxyhmf
sgd l]hm deedbsr ne RDR ]mc duhcdmbd ne o]sgnknfx ]mc
sgdhq hmsdq]bshnm deedbs nm sgdrd sgqdd rdsr ne cdodmcdms
u]qh]akdr- Sgqdd svn,v]x ?MNU?r vdqd bnmctbsdc nm
o]hm bqdchahkhsx* orxbgnknfhb]k ]ssqhatshnmr* ]mc sgd
L]mbgdrsdq Sqh]fd rbnqd* qdrodbshudkx-
Pdrtjsr
ISmhotkSshnm Bgdbj
Ne sgd 047 o]qshbho]msr* 23 vdqd dwbktcdc eqnl sgd ]m]k,
xrdr adb]trd sgdx e]hkdc sgd l]mhotk]shnm bgdbjr-
Rodbhehb]kkx* 02 o]qshbho]msr vdqd dwbktcdc adb]trd sgdx
hcdmshehdc sgd o]shdms&r o]hm ]r ]btsd ’o]hm edks enq kdrr
sg]m entq gntqr nq entq c]xr(* svn e]hkdc sn hcdmshex sgd
o]shdms&r RDR* ]mc 08 e]hkdc sn qdb]kk duhcdmbd ne o]sgnk,
nfx- Sgtr* ] sns]k ne 013 o]qshbho]msr vdqd hmbktcdc hm
sgd ]m]kxrdr- Mn rnbhncdlnfq]oghb cheedqdmbdr vdqd
entmc adsvddm hmbktcdc ]mc dwbktcdc o]qshbho]msr* dw,
bdos enq odqrnm]k dwodqhdmbd ne BO ’P ’0( ¼ 4-51* F
/-/4(: sgdqd vdqd lnqd hmchuhct]kr mns qdonqshmf odqrnm]k
dwodqhdmbd vhsg BO ]lnmf sgnrd vgn vdqd dwbktcdc-
RDR l]mhotk]shnm v]r rtbbdrretk* ]r sgdqd vdqd rhfmheh,
b]ms cheedqdmbdr hm RDR odqbdoshnm adsvddm sgd svn bnm,
chshnmr ’r ’011( ¼ fl1/-10* F /-/0: LKnvRDR ¼ 3-22* RC
¼ /-87: ur LGhfgRDR ¼ 7-05* RC ¼ 0-01(-
IShm Ceedbsr ne PCP nm MShm 8rrdrrldms Smc
ISmSfdldms MqSbshbdr
? ltkshu]qh]sd l]hm deedbs ne o]shdms RDR v]r entmc enq
o]hm hmsdmrhsx q]shmfr ’2 ’1* 008( ¼ 2-40* F /-/4* ds]1 ¼
/-/5(- Tmhu]qh]sd ]m]kxrhr ’S]akd 1( rgnvdc sg]s sgd
ghfgdq,RDR o]shdms v]r odqbdhudc ]r g]uhmf lnqd hmsdmrd
o]hm sg]m sgd knvdq,RDR o]shdms hm ansg nudq]kk o]hm ]mc
.oPma^
Pn ds Pi
o]hm ctqhmf lnudldms hmsdmrhsx ]rrdrrldmsr- Mn rhfmheh,
b]ms l]hm deedbsr ne RDR vdqd entmc nm o]qshbho]msr& itcf,
ldmsr ne o]hm chr]ahkhsx* rdudqhsx ne sgd bkhmhb]k rhst]shnm*
nq bqdchahkhsx* nq hm sgdhq hmsdmshnmr ne needqhmf rtoonqs ]mc
]ssqhatshnmr ne o]shdms v]hshmf shld ’L]mbgdrsdq Sqh]fd(-
IShm Ceedbsr ne Cuhcdmbd ne MSsgnknfx nm MShm
8rrdrrldms Smc ISmSfdldms MqSbshbdr
Qdrtksr rgnvdc rhfmhehb]ms ltkshu]qh]sd l]hm deedbsr ne
duhcdmbd ne o]sgnknfx nm o]hm hmsdmrhsx ’2 ’1* 008( ¼
1-80* F ¼ /-/48* ds]1 ¼ /-/4(* o]hm chr]ahkhsx ]mc rdudqhsx
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ne bkhmhb]k rhst]shnm ld]rtqdr ’2 ’1* 008( ¼ 2-/5* F ¼
/-/4* ds]1 ¼ /-/4(* ]mc hmsdmshnmr ne needqhmf rtoonqs ’2
’1* 008( ¼ 4-28* F /-/0* ds]1 ¼ /-/7(- Tmhu]qh]sd sdrsr
’S]akd 1( rgnvdc sg]s hm sgd ]ardmbd ne duhcdmbd ne o],
sgnknfx* o]qshbho]msr odqbdhudc sgd o]shdms&r o]hm ]r kdrr
hmsdmrd nudq]kk ]mc ctqhmf lnudldms* sgd o]hm ]r kdrr chr,
]akhmf* ]mc sgd bkhmhb]k rhst]shnm ]r kdrr rdudqd: sgd o]hm
v]r lnqd ]ssqhatsdc sn orxbgnknfhb]k b]trdr* ]mc sgdx
vdqd kdrr vhkkhmf sn needq hmrsqtldms]k rtoonqs- Mn rhfmhe,
hb]ms l]hm deedbsr ne duhcdmbd ne o]sgnknfx vdqd entmc
nm o]hm bqdchahkhsx itcfldmsr-
EmsdqSbshnm Ceedbsr Adsvddm PCP Smc Cuhcdmbd ne
MSsgnknfx nm MShm 8rrdrrldms Smc ISmSfdldms
MqSbshbdr
? anqcdqkhmd ltkshu]qh]sd hmsdq]bshnm deedbs adsvddm duh,
cdmbd ne o]sgnknfx ]mc o]shdms RDR v]r entmc enq o]hm hm,
sdmrhsx ld]rtqdr ’2 ’1* 008( ¼ 1-64* F ¼ /-/6* ds]1 ¼
/-/3(- Tmhu]qh]sd sdrsr ’S]akd 1( rgnvdc sg]s ]ksgntfg sgd
hmsdq]bshnm enq nudq]kk o]hm hmsdmrhsx v]r rhfmhehb]ms ’F
/-/0(* sgd hmsdq]bshnm enq o]hm ctqhmf lnudldms v]r nmkx
l]qfhm]kkx rhfmhehb]ms ’F ¼ /-/6(- Rhlokd deedbs ]m]kxrdr
rgnvdc sgd r]ld o]ssdqm ne qdrtksr enq ansg o]hm hmsdmrhsx
q]shmfr ’Ehftqd 1(- Sgd ghfg,RDR o]shdms&r o]hm v]r odq,
bdhudc ]r lnqd hmsdmrd sg]m sgd knv,RDR o]shdms&r o]hm* ats
nmkx vgdm duhcdmbd ne o]sgnknfx v]r oqdrdms- ?krn* o]hm
hm sgd oqdrdmbd ne duhcdmbd ne o]sgnknfx v]r itcfdc ]r
lnqd hmsdmrd sg]m hm sgd ]ardmbd ne duhcdmbd ne o]sgnknfx*
ats nmkx enq sgd ghfg,RDR o]shdms- Mn rhfmhehb]ms hmsdq]b,
shnm deedbsr vdqd entmc nm o]qshbho]msr& itcfldmsr ne o]hm
chr]ahkhsx* rdudqhsx ne sgd bkhmhb]k rhst]shnm* nq o]hm bqdchahk,
hsx* nq hm sgdhq hmsdmshnmr ne needqhmf rtoonqs ]mc sgdhq ]ssqh,
atshnmr ne o]shdms v]hshmf shld ’L]mbgdrsdq Sqh]fd(-
Bnmbktrhnmr
?r hm Rstcx 0* ntq qdrtksr rgnvdc sg]s o]shdms RDR hmekt,
dmbdc mtqrdr& o]hm ]rrdrrldmsr ats mns sgdhq l]m]fdldms
oq]bshbdr- O]qsh]kkx rtoonqshmf gxonsgdrhr 0* ]mc qdokhb]s,
hmf Rstcx 0 ehmchmfr* qdrtksr rgnvdc sg]s mtqrdr odqbdhudc
sgd ghfgdq,RDR o]shdms ]r g]uhmf rkhfgskx lnqd hmsdmrd
o]hm sg]m sgd knvdq,RDR o]shdms- ?r dwodbsdc* ]mc hm khmd
vhsg oqduhntr rstchdr X2* 3* 05* 06* 15[* hm sgd oqdrdmbd ne
duhcdmbd ne o]sgnknfx* mtqrdr itcfdc sgd o]shdms&r o]hm ]r
lnqd hmsdmrd ]mc chr]akhmf* ]ssqhatsdc sgd o]hm sn ] kdrrdq
dwsdms sn orxbgnknfhb]k e]bsnqr* bnmrhcdqdc sgd bkhmhb]k
BiPrrerl em CPem BPod 10.0

STajd 1, LWhm Wmc hmsdpWbshnm tmhuWphWsd deedbsr ne oWshdms rnbhndbnmnlhb rsWstr Wmc duhcdmbd ne oWsgnknfx nm oWhm Wrrdrrldms Wmc
lWmWfdldms opWbshbdr ’Rstcx 1(

RDR DO RDR)DO

L ’RC( L ’RC(

Knv Ghfg 2 ?ardms Oqdrdms E E

O]hm ]rrdrrldms
O]hm hmsdmrhsx nm lnudldms 4-// ’0-53( 4-68 ’0-55( 6-.7) .-.5 4-/4 ’0-48( 4-62 ’0-62( 4-23)) .-.3 4-23) .-.3
Nudq]kk o]hm hmsdmrhsx 4-20 ’0-33( 4-86 ’0-58( 4-17) .-.3 4-2/ ’0-43( 4-86 ’0-48( 4-52) .-.4 2-17– .-.2
O]hm chr]ahkhsx 4-/6 ’/-63( 4-/1 ’/-71( /-08 /-// 3-77 ’/-70( 4-10 ’/-66( 4-45) .-.3 0-67 /-/1
Rdudqhsx ne bkhmhb]k rhst]shnm 3-06 ’/-57( 3-14 ’/-56( /-25 /-// 3-/7 ’/-58( 3-23 ’/-51( 3-67) .-.3 /-034 /-//
O]hm bqdchahkhsx 4-16 ’0-//( 4-22 ’/-84( /-00 /-// 4-05 ’0-/3( 4-33 ’/-77( 1-43 /-/1 /-/4 /-//

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Orxbgnknfhb]k ]ssqhatshnmr 2-1/ ’/-78( 2-23 ’/-83( /-78 /-/0 2-40 ’/-81( 2-/4 ’/-77( 7-25)) .-.6 /-/4 /-//
O]hm l]m]fdldms
Hmrsqtldms]k rtoonqs 4-07 ’/-88( 4-1/ ’/-73( /-// /-// 4-/0 ’/-86( 4-25 ’/-72( 3-56) .-.3 0-55 /-/0
Dlnshnm]k rtoonqs 4-3/ ’/-88( 4-18 ’/-88( /-35 /-// 4-30 ’0-/2( 4-17 ’/-8/( /-53 /-/0 1-18 /-/1

RDR ¼ rnbhndbnmnlhb rs]str-

)F /-/4: ))F " /-/0: )))F " /-//0- –/-/6-

)))
))
))
6 5,41
5,31

5
4,0 4,12 4,28 4,26
4*. 4*.
4
OShm hmsdmrhsw
3

.
Hnv PDP Eheg PDP Hnv PDP Eheg PDP
OShm hmsdmrhsw lnudldms( OShm hmsdmrhsw nudpSii(
OShm hmsdmrhsw ctphme lnudldms LudpSii oShm hmsdmrhsw
DO Sardms DO opdrdms

Dhftpd 1, HmsdpWbshnm deedbs adsvddm oWshdms rnbhndbnmnlhb rsWstr Wmc duhcdmbd ne oWsgnknfx nm oWhm hmsdmrhsx pWshmfr ’Rstcx 1(-
)C /-/2: ))C " /-/0: )))C " /-//0-

rhst]shnm sn ad lnqd rdudqd* ]mc vdqd lnqd vhkkhmf sn
oqnuhcd sgd o]shdms hmrsqtldms]k rtoonqs- Vd chc mns
bnmehql ntq gxonsgdrhr 1 ]ants sgd k]qfdq deedbs ne duh,
cdmbd ne o]sgnknfx nm o]hm ]rrdrrldms ]mc l]m]fdldms
oq]bshbdr snv]qc sgd knvdq,RDR o]shdms- Nm sgd bnmsq]qx*
ntq qdrtksr rgnvdc sgd noonrhsd o]ssdqm qdf]qchmf o]hm
hmsdmrhsx ]rrdrrldmsr: o]hm v]r hmcddc odqbdhudc ]r lnqd
hmsdmrd vgdm duhcdmbd ne o]sgnknfx v]r oqdrdms sg]m ]a,
rdms* ats nmkx enq sgd ghfgdq,RDR o]shdms- Lnqdnudq* hm
sgd oqdrdmbd ne duhcdmbd ne o]sgnknfx* sgd ghfg,RDR
o]shdms&r o]hm ’nudq]kk ]mc ctqhmf lnudldms( v]r odq,
bdhudc ]r lnqd hmsdmrd sg]s sgd knv,RDR o]shdms&r o]hm-
Chrbtrrhnm
Sghr rstcx ]hldc sn dwodqhldms]kkx sdrs sgd deedbsr ne
o]shdmsr& rnbhndbnmnlhb rs]str nm mtqrdr& o]hm ]rrdrrldms
]mc l]m]fdldms oq]bshbdr ]mc sn hmudrshf]sd vgdsgdq
o]shdms RDR lncdq]sdc sgd deedbsr ne qdkdu]ms bkhmhb]k btdr
nm o]hm ]rrdrrldms ]mc l]m]fdldms oq]bshbdr* m]ldkx
o]shdms chrsqdrr ]mc duhcdmbd ne o]sgnknfx-
Ntq ehqrs gxonsgdrhr* sg]s sgd knvdq,RDR o]shdms&r o]hm
vntkc ad tmcdq]rrdrrdc ]mc tmcdqsqd]sdc ]r bnlo]qdc
vhsg sgd ghfgdq,RDR o]shdms&r o]hm* v]r o]qsh]kkx bnm,
ehqldc- Hm sdqlr ne o]hm ]rrdrrldms* ]r dwodbsdc* mtqrdr
itcfdc sgd o]hm ne sgd knvdq,RDR o]shdms ]r rkhfgskx kdrr
hmsdmrd ’ansg nudq]kk o]hm ]mc o]hm ctqhmf lnudldms( ]r
bnlo]qdc vhsg sgd o]hm ne sgd ghfgdq,RDR o]shdms-
Cdrohsd sgd rl]kk sn ldchtl deedbs rhydr* sghr o]ssdqm v]r
bnmrhrsdms ]bqnrr sgd svn rstchdr ]mc hr hm khmd vhsg oqduh,
ntr qdrd]qbg dwoknqhmf q]bh]k.dsgmhb chro]qhshdr ’trdc ]r ]
oqnwx ne RDR(* vghbg rgnvdc sg]s gd]ksg b]qd oqnedrrhn,
m]kr tmcdqdrshl]sdc sgd o]hm ne ldladqr ne dsgmhb lh,
mnqhsx fqntor X0/* 22[- Rhlhk]q qdrtksr vdqd ]krn entmc
]lnmf k]xodnokd* vgn ]ssqhatsdc kdrr o]hm sn sgnrd odq,
bdhudc ]r g]uhmf ] knvdq rnbh]k rs]str X23[-
10.1
Sgd qd]rnm sg]s knv,RDR hmchuhct]kr rddl sn ad odq,
bdhudc ]r kdrr rdmrhshud sn o]hm lhfgs ad ]rrnbh]sdc vhsg
odqbdhudc khed g]qcrgho- Hmcddc* ] edv rstchdr bnmctbsdc
hm sgd Tmhsdc Rs]sdr g]ud rgnvm sg]s adb]trd ak]bj odn,
okd ]qd nesdm odqbdhudc ]r khuhmf ] kdrr oqhuhkdfdc khed etkk
ne g]qcrgho* sgdx ]qd ]krn odqbdhudc ]r lnqd qnatrs*
sntfg* ]mc* bnmrdptdmskx* kdrr rdmrhshud sn o]hm X0*23[-
?mnsgdq onrrhakd ldbg]mhrl ]bbntmshmf enq sgd RDR de,
edbs nm o]hm hmsdmrhsx ]rrdrrldmsr l]x ad sgd oqnbdrr ne
cdgtl]mhy]shnm* sg]s hr* odqbdhuhmf nsgdqr ]r kdrr sg]m
gtl]m X24[- Hmcddc* rnbhndbnmnlhb]kkx chr]cu]ms]fdc
odnokd ]qd nesdm cdmhdc bg]q]bsdqhrshbr sg]s chrshmfthrg
gtl]mr eqnl ]mhl]kr X25[* vghbg l]x ]bbntms enq odq,
bdhuhmf sgdl ]r lnqd o]hm snkdq]ms X26[- Sgd qnkd ne odq,
bdhudc g]qcrgho ]mc ]mhl]khrshb cdgtl]mhy]shnm X05*06[
nm RDR ah]rdr hm gd]ksg b]qd oqnedrrhnm]kr& o]hm ]rrdrr,
ldms ]mc l]m]fdldms oq]bshbdr hr* gnvdudq* xds sn ad
hmudrshf]sdc-
?r enq sgd deedbsr ne o]shdms RDR nm o]hm hmsdmrhsx
]rrdrrldmsr* gxonsgdrhr 0 v]r bnmehqldc enq orxbgnknfh,
b]k ]ssqhatshnmr sn o]hm: ]krn* sgd qdrtksr rddl sn rtffdrs ]
rl]kk RDR deedbs nudq o]hm bqdchahkhsx ats nmkx hm sgd oqdr,
dmbd ne chrsqdrr btdr- ?r bnlo]qdc vhsg sgd ghfg,RDR
o]shdms&r o]hm* sgd knv,RDR o]shdms&r o]hm v]r rkhfgskx
lnqd ]ssqhatsdc sn orxbgnknfhb]k b]trdr- Sgdrd qdrtksr ]qd
bnmrhrsdms vhsg oqduhntr qdrd]qbg rgnvhmf sg]s sgd ]bsh,
u]shnm ne bnllnm rdmrd lncdkr ne rnl]shy]shnm ’h-d-* sgd
adkhde sg]s ogxrhb]k rxlosnlr qdrtks eqnl sgd rnl]shy],
shnm ne rsqdrr( hr lnqd eqdptdms vgdm hmsdqoqdshmf vnl,
dm&r o]hm X2[ ]mc ]krn sgd rxlosnlr ne knvflrnbh]k rs]str
hmchuhct]kr X0*26[- S]jhmf sghr duhcdmbd snfdsgdq* hs hr mns
rtqoqhrhmf sg]s sgd vnl]m ne knv RDR g]c gdq o]hm
rkhfgskx lnqd ]ssqhatsdc sn orxbgnknfhb]k e]bsnqr sg]m sgd
vnl]m ne ghfg RDR-
Sgd qd]rnm vgx* hm sgd oqdrdmbd ne chrsqdrr btdr* sgd
knv,RDR vnl]m&r o]hm rddldc sn ad odqbdhudc ]r kdrr
bqdchakd sg]m sgd ghfg,RDR vnl]m&r o]hm hr kdrr bkd]q-
Nmd bntkc ]qftd sg]s hs bntkc ad bnqnkk]qx sn sgd RDR de,
edbs nm orxbgnknfhb]k ]ssqhatshnmr* ]r sgd k]ssdq ]qd rnld,
shldr ]rrnbh]sdc vhsg knvdq o]hm bqdchahkhsx X05[-
Gnvdudq* hm ansg rstchdr* orxbgnknfhb]k ]ssqhatshnmr
vdqd mns rhfmhehb]mskx bnqqdk]sdc vhsg o]hm bqdchahkhsx- Hs
hr onrrhakd sg]s sgd odqbdoshnm ne knv,RDR o]hm o]shdmsr ]r
adhmf mddcx ]mc zcqtf rddjdqr† X7[ l]x g]ud bnmsqhatsdc
sn sghr sqdmc- Gnvdudq* lnqd qdrd]qbg hr mddcdc sn bnm,
ehql sghr sdmcdmbx ]mc sn dw]lhmd sgd bnmsdmsr ne rsdqdn,
sxohb]k qdoqdrdms]shnmr ne knv,RDR ur ghfg,RDR o]hm
o]shdmsr sn hmbqd]rd ntq ]ahkhsx sn ]bbntms enq RDR chro]q,
hshdr hm o]hm b]qd-
Hm sdqlr ne mtqrdr& hmsdmshnmr ne o]hm l]m]fdldms*
ntq gxonsgdrdr vdqd mns bnmehqldc- O]shdms RDR chc mns
g]ud ] rhfmhehb]ms deedbs nm mtqrdr& hmsdmshnmr ne needqhmf
dlnshnm]k nq hmrsqtldms]k rtoonqs* mnq chc sgdx g]ud ]m
deedbs nm sgd L]mbgdrsdq Sqh]fd rbnqd- Sghr o]ssdqm ne
ehmchmfr hr hm khmd vhsg oqduhntr rstchdr nm rnbh]k chro]q,
hshdr hm o]hm b]qd* vgdqd ah]rdr bntkc hmcddc ad entmc hm
o]hm ]rrdrrldmsr ats mns hm o]hm l]m]fdldms oq]bshbdr
.oPma^
Pn ds Pi
X2* 27[- Sghr o]ssdqm l]x dudmst]kkx ad tmcdqrsnnc ]r ]
qdrtks ne ] chrbnmmdbshnm adsvddm hlokhbhs ah]rdr ]mc ]b,
st]k adg]uhnq- Hm e]bs* ]r bnlo]qdc vhsg o]hm l]m]fd,
ldms hmsdmshnmr* o]hm ]rrdrrldmsr l]x ad lnqd
hmektdmbdc ax hlokhbhs ah]rdr* vghkd sqd]sldms cdbhrhnmr
l]x lnqd hmektdmbdc ax qdekdbshud ]mc hmsdmshnm]k bnfmh,
shud oqnbdrrdr ]mc* bnmrdptdmskx* lnqd hmektdmbdc ax rn,
bh]k cdrhq]ahkhsx ]mc.nq ] mnql ne gd]ksg b]qd dpthsx-
?krn* sgd hmektdmbd ne rnbh]k cdrhq]ahkhsx ]mc.nq gd]ksg
b]qd dpthsx mnql l]x ad o]qshbtk]qkx r]khdms enq l]m]fd,
ldms oq]bshbdr khjd needqhmf dlnshnm]k ]mc hmrsqtldms]k
Downloaded from https://academic.oup.com/painmedicine/article/20/11/2094/5540715 by guest on 23 January 2023
rtoonqs sn ] o]hm o]shdms- Sgd ]ardmbd ne RDR ah]rdr hm
sgd L]mbgdrsdq Sqh]fd qdrtksr l]x ]krn g]ud addm
]bbntmsdc enq ax sgd e]bs sg]s lnrs ne ntq o]qshbho]msr
chc mns g]ud ]mx dwodqhdmbd hm vnqjhmf hm dldqfdmbx
cdo]qsldmsr* vgdqd sghr rxrsdl hr fdmdq]kkx hlokdldmsdc-
Hm ntq rdbnmc gxonsgdrhr* vd dwodbsdc sg]s ghfg RDR
vntkc ateedq sgd cdsqhldms]k deedbsr ne sgd oqdrdmbd ne
chrsqdrr btdr ]mc ]ardmbd ne duhcdmbd ne o]sgnknfx nm
mtqrdr& o]hm ]rrdrrldms ]mc l]m]fdldms oq]bshbdr- Sghr
gxonsgdrhr* gnvdudq* v]r nmkx bnmehqldc enq chrsqdrr
btdr: hmcddc* nmkx sgd o]hm bqdchahkhsx ne sgd knv,RDR
vnl]m v]r rkhfgskx ghmcdqdc ax sgd oqdrdmbd ne chrsqdrr-
Sgdrd qdrtksr o]qsh]kkx dwsdmc oqduhntr ehmchmfr rtoonqs,
hmf sgd mdf]shud deedbsr ne chrsqdrr btdr nm o]hm ]rrdr,
rldmsr hm fdmdq]k X05[ ]mc ]rrdrrldmsr ne vnldm&r o]hm
hm o]qshbtk]q X2*28[- Sgd mnudksx ne sgdrd ehmchmfr khdr hm
sgd e]bs sg]s sgdx onhms sn sgd oqnsdbshud qnkd ne ghfg RDR
nm sgd cdsqhldms]k deedbsr ne chrsqdrr nm vnldm&r o]hm ]r,
rdrrldms- Lnqd rodbhehb]kkx* sgdx l]x ad rtffdrshmf sg]s
ghfg,RDR vnldm&r chrsqdrr hr kdrr khjdkx sn ]bshu]sd bnl,
lnm rdmrd lncdkr ne rnl]shy]shnm* vghbg nesdm kd]cr sn
knvdq o]hm bqdchahkhsx itcfldmsr X2* 28[- Sghr gxonsgdrhr*
gnvdudq* hr xds sn ad chqdbskx sdrsdc-
?r enq duhcdmbd ne o]sgnknfx* ntq qdrtksr vdqd bnm,
sq]qx sn ntq gxonsgdrhr- Vgdm duhcdmbd ne o]sgnknfx v]r
oqdrdms* mtqrdr q]sdc sgd o]hm ne sgd ghfg,RDR o]shdms ]r ]
ahs lnqd hmsdmrd sg]m vgdm duhcdmbd ne o]sgnknfx v]r
]ardms- Gnvdudq* sgd knv,RDR o]shdms&r o]hm hmsdmrhsx
’ansg ctqhmf lnudldms ]mc nudq]kk( v]r dpt]kkx
]rrdrrdc* qdf]qckdrr ne sgd ]ardmbd nq oqdrdmbd ne duh,
cdmbd ne o]sgnknfx- Sgd qd]rnm vgx sghr o]ssdqm ne ehmc,
hmfr hr hmbnmrhrsdms vhsg ntq oqdchbshnmr hr g]qcdq sn
]bbntms enq* ]r vd g]ud xds khsskd jmnvkdcfd nm sgd rod,
bhehb oqnbdrrdr tmcdqkxhmf mtqrdr& o]hm ]rrdrrldmsr-
IhlhsWshnmr* Etstpd Chpdbshnmr enp PdrdWpbg* Wmc
HlokhbWshnmr
?r vhsg ]mx nsgdq ohdbd ne qdrd]qbg* ntq rstchdr oqdrdms
rnld khlhs]shnmr* vghbg onhms sn chqdbshnmr enq etstqd qd,
rd]qbg- Cdrohsd sgd trdetkmdrr ne dwodqhldms]k rstchdr
vhsg vqhssdm uhfmdssdr sn sdrs b]tr]k qdk]shnmrghor* sgdx
qdoqdrdms m]stq]k bkhmhb rbdm]qhnr hm ] o]qsh]k ]mc ’nudq(,
rhlokhehdc v]x* vghbg b]m q]hrd rnld bnmbdqmr qdf]qchmf
rstchdr& dbnknfhb]k ]mc bnmrsqtbs u]khchsx- ?ksgntfg sgd
trd ne ] uhcdn ne ] qd]k o]shdms vghkd rgd v]r odqenqlhmf
BiPrrerl em CPem BPod
]m hmctbdc o]hm ]bshuhsx l]x g]ud bnmsqhatsdc sn
hmbqd]rhmf sgd rstchdr& dbnknfhb]k u]khchsx* sgd fdmdq]khy],
shnm ne ehmchmfr sn qd]k bkhmhb]k bnmsdwsr ]mc sn nsgdq
jhmcr ne RDR l]mhotk]shnmr ’d-f-* nsgdq sxodr ne oqnedr,
rhnmr( rgntkc ad cnmd vhsg b]tshnm- Hmcddc* nm sgd nmd
g]mc* rnld ne ntq deedbs rhydr vdqd rl]kk* q]hrhmf ptdr,
shnmr qdf]qchmf sgdhq onsdmsh]k bkhmhb]k rhfmhehb]mbd hm qd]k
bnmsdwsr- Nm sgd nsgdq g]mc* vd g]ud l]mhotk]sdc RDR
ax dwbktrhudkx l]mhotk]shmf o]shdms oqnedrrhnm.dctb]shnm
vghkd jddohmf bnmrs]ms hlonqs]ms btdr enq rnbh]k bk]rr
b]sdfnqhy]shnm ’d-f-* ogxrhb]k ]ood]q]mbd* onrstqd* cd,
ld]mnq( X3/[* vghbg l]x g]ud o]qsh]kkx ]bbntmsdc enq
sgd rl]kk deedbs rhydr- Fhudm sgd bnlokdwhshdr ne rnbh]k
bk]rr qdbnfmhshnm ]mc b]sdfnqhy]shnm oqnbdrrdr X3/[* et,
stqd rstchdr rgntkc etqsgdq dw]lhmd bk]rrhrl deedbsr nm
o]hm ]rrdrrldms ]mc l]m]fdldms oq]bshbdr hm m]stq]khrshb
rdsshmfr-
Hs hr hlonqs]ms sn mnsd sg]s ntq uhfmdssdr qdoqdrdmsdc ]
o]shdms chrok]xhmf lncdq]sd kdudkr ne o]hm adg]uhnqr*
vghbg l]x g]ud ]krn ghmcdqdc sgd cdsdbshnm ne RDR
ah]rdr- Hmcddc* ]r oqduhntr rstchdr g]ud rgnvm X05[*
ghfgdq kdudkr ne o]hm hmsdmrhsx* ax hmbqd]rhmf sgd ]lahft,
hsx ne sgd bkhmhb]k rhst]shnm* l]x hmbqd]rd sgd khjdkhgnnc ne
]rrdrrldms ah]rdr- Etstqd rstchdr rgntkc dwoknqd sgd
lncdq]shmf qnkd ne o]hm hmsdmrhsx nm RDR ah]rdr hm o]hm
]rrdrrldms ]mc sqd]sldms-
?krn* vd cn mns jmnv vgdsgdq sgd r]ld o]ssdqm ne
qdrtksr bntkc ad entmc enq l]kd,sn,l]kd ]rrdrrldmsr nq
nsgdq rdw,chrbnqc]ms ]rrdrrldmsr ’h-d-* ] l]kd mtqrd
]rrdrrhmf ] edl]kd o]shdms nq ] edl]kd mtqrd ]rrdrrhmf ]
l]kd o]shdms(- Hmcddc* oqduhntr duhcdmbd g]r rgnvm
sg]s o]shdmsr& rdw ]mc gd]ksg b]qd oqnedrrhnm]kr& rdw X2*
30*31[ hmektdmbd o]hm ]rrdrrldms ]mc l]m]fdldms
oq]bshbdr- Enq sghr qd]rnm* etstqd rstchdr rgntkc dw,
oknqd he sghr o]ssdqm ne ehmchmfr dldqfdr vgdm l]kd
o]shdmsr ]mc l]kd gd]ksg b]qd oqnedrrhnm]kr ]qd ]krn hm,
bktcdc- ?krn* nmkx mtqrdr ]mc mtqrhmf rstcdmsr vdqd hm,
bktcdc* vghbg khlhsr ntq bnmbktrhnmr qdf]qchmf o]hm
sqd]sldms cdbhrhnmr- ?ksgntfg ] edv oqduhntr rstchdr
entmc mn deedbsr ne o]shdms RDR nm ogxrhbh]mr& o]hm ]r,
rdrrldms ]mc l]m]fdldms oq]bshbdr X01*02[* rnld
pt]khs]shud ehmchmfr g]ud hmcddc rtffdrsdc sg]s cdbh,
rhnmr qdf]qchmf o]hm og]ql]bnknfhb]k sqd]sldmsr l]x
ad hmektdmbdc ax o]shdmsr& RDR X7[- ?r rtbg* lnqd et,
stqd rstchdr rgntkc hmbktcd ogxrhbh]mr ]mc dwodqhldm,
s]kkx sdrs sgd deedbs ne o]shdms RDR nm cnbsnqr&
sqd]sldms cdbhrhnmr-
Hs rgntkc ]krn ad mnsdc sg]s ntq ehmchmfr ]qd sn rnld
dwsdms cdrbqhoshud ]mc cn mns s]o hmsn sgd bnfmhshud ]mc.
nq lnshu]shnm]k ldch]shmf oqnbdrrdr sg]s l]x ]bbntms
enq RDR ah]rdr hm o]hm b]qd- Adxnmc dw]lhmhmf he rtbg
ah]rdr dwhrs* qdrd]qbgdqr rgntkc dwoknqd vghbg ldbg],
mhrlr l]x tmcdqkhd sgdl ’d-f-* g]qcrgho* cdgtl]mhy],
shnm* dlo]sgx(* ]knmf vhsg sgd rsdqdnsxohb]k
ld]mhmfr ]rrnbh]sdc vhsg o]hm dwodqhdmbdr ne odnokd
vhsg cheedqdms RDR- Sgd hcdmshehb]shnm ne rtbg rsdqdnsxod
bnmsdmsr ]mc ldch]shmf ldbg]mhrlr hr ne ghfg
10.2
hlonqs]mbd enq cdudknohmf hmsdqudmshnmr s]qfdshmf RDR
ah]rdr hm o]hm b]qd-
Cdrohsd sgdrd khlhs]shnmr* sghr rstcx ad]qr hlonqs]ms
hlokhb]shnmr lnrskx enq qdrd]qbg* ats ]krn* ]mc dudmst,
]kkx* enq bkhmhb]k oq]bshbd- ?ksgntfg ltbg qdrd]qbg g]r
addm bnmctbsdc nm fdmcdq X4[ ]mc q]bd ah]rdr hm o]hm
b]qd X1[* khsskd ]ssdmshnm g]r addm o]hc sn sgd qnkd ne rn,
bh]k bk]rr ah]rdr hm o]hm ]rrdrrldms ]mc l]m]fdldms
oq]bshbdr- ?r o]shdms RDR hr ] bknrd oqnwx ne rnbh]k
bk]rr* sghr o]odq hr* sn sgd adrs ne ntq jmnvkdcfd* nmd
ne ] edv sn oqnuhcd dwodqhldms]k duhcdmbd nm sgd oqdr,
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dmbd ne bk]rrhrl hm o]hm ]rrdrrldmsr- Hs ]krn onhmsr sn
sgd onsdmsh]k ateedqhmf qnkd ne RDR ]f]hmrs sgd cdsqhldm,
s]k deedbs ne bdqs]hm bkhmhb]k btdr nm o]hm ]rrdrrldmsr-
Nudq]kk* sgdrd ehmchmfr l]hmkx bnmsqhatsd sn ghfgkhfgshmf
sgd mddc sn etqsgdq hmudrshf]sd sgd qnkd ne RDR.rnbh]k
bk]rr hm o]hm b]qd ]mc hsr tmcdqkxhmf ld]mhmfr ]mc oqn,
bdrrdr- Q]hrhmf ]v]qdmdrr ne sgd onsdmsh]k cdsqhldms]k
hmektdmbd ne bk]rrhrl hm o]hm ]rrdrrldms l]x bnmsqhatsd
sn sgd cdudknoldms ne lnqd ]bbtq]sd bkhmhb]k oq]bshbdr-
Hmcddc* hs hr nmkx tonm rtbg jmnvkdcfd sg]s dlohqhb]kkx
a]rdc hmsdqudmshnmr l]x hm sgd etstqd ad cdudknodc sn
oqnlnsd rnbh]k dpthsx hm o]hm b]qd- Sghr o]odq hr ] rsdo,
ohmf rsnmd hm sg]s chqdbshnm-
Pdedpdmbdr
0- Gneel]m JL* Sq]v]ksdq R* ?ws IQ* Nkhudq LM-
Q]bh]k ah]r hm o]hm ]rrdrrldms ]mc sqd]sldms qdbnl,
ldmc]shnmr* ]mc e]krd adkhder ]ants ahnknfhb]k cheedq,
dmbdr adsvddm ak]bjr ]mc vghsdr- Oqnb M]sk ?b]c Rbh
T R ? 1/05:002’05(93185fl2/0-
1- S]hs QB* Bgham]kk IS- Q]bh]k.dsgmhb chro]qhshdr hm sgd
]rrdrrldms ]mc sqd]sldms ne o]hm9 Orxbgnrnbh]k odq,
rodbshudr- ?l Orxbgnk 1/03:58’1(9020fl30-
2- Adqm]qcdr RE* Khl] LK- ? bnmsdwst]k ]ooqn]bg nm
rdw,qdk]sdc ah]rdr hm o]hm itcfdldmsr9 Sgd lncdq]snq
deedbsr ne duhcdmbd ne o]sgnknfx ]mc o]shdmsr& chrsqdrr
btdr nm mtqrdr& itcfdldmsr ne bgqnmhb knv,a]bj o]hm-
Orxbgnk Gd]ksg 1/00:15’01(90531fl47-
3- Adqm]qcdr RE* Khl] LK- Nm sgd bnmsdwst]k m]stqd ne
rdw,qdk]sdc ah]rdr hm o]hm itcfldmsr9 Sgd deedbsr ne
o]hm ctq]shnm* o]shdms&r chrsqdrr ]mc itcfd&r rdw- Dtq I
O]hm 1/00:04’8(984/fl6-
4- R]ltknuhsy ?* Fqdlxq H* Dqhjrrnm D* Gdmrhmf F-
zAq]ud ldm† ]mc zdlnshnm]k vnldm†9 ? sgdnqx,
fthcdc qduhdv nm fdmcdq ah]r hm gd]ksg,b]qd ]mc fdm,
cdqdc mnqlr snv]qcr o]shdmsr vhsg bgqnmhb o]hm- O]hm
Qdr L]m]f- 1/07903: gssor9..cnh-nqf.0/-0044.1/07.
5247513-
5- Knss A- Bnfmhshud ]mc adg]uhnq]k chrs]mbhmf eqnl sgd
onnq- ?l Orxbgnk 1//1:46’1(90//fl0/-
6- Knss A- Sgd rnbh]k orxbgnknfx ne bk]rr ]mc bk]rrhrl-
?l Orxbgnk 1/01:56’7(954/fl7-
7- Gnkkhmfrgd]c M?* L]ssgh]r LR* A]hq L* Ghqrg ?S-
Gd]ksgb]qd oqnuhcdqr& odqbdoshnmr ne rnbhndbnmnlh,
b]kkx chr]cu]ms]fdc o]shdmsr vhsg bgqnmhb o]hm9 ?
10.3
pt]khs]shud hmudrshf]shnm- I Gd]ksg Chro]q Qdr Oq]bs
1/05:8924fl33-
8- Odsshs JD* Stqmdq IR* Jhmcq]s IJ* ds ]k- Deedbs ne rnbhn,
dbnmnlhb rs]str ah]r nm ldchb]k rstcdmsflo]shdms
hmsdq]bshnmr trhmf ]m dldqfdmbx ldchbhmd rhltk]shnm-
?DL Dctb Sq]hm 1/06:0’1(9015fl20-
0/- Inxms L* Sq]hm LJ* Qnaahmr AV* G]ksdql]m IR*
B]hnk] D* Enqstm] QI- Sgd hlo]bs ne mdhfganqgnnc rn,
bhndbnmnlhb rs]str ]mc q]bd nm sgd oqdrbqhahmf ne
nohnhcr hm dldqfdmbx cdo]qsldmsr sgqntfgnts sgd
Tmhsdc Rs]sdr- I Fdm Hmsdqm Ldc 1/02:17’01(905/3fl0/-
00- G]hcdq ?G* Rdwsnm I* Rqhq]l M* ds ]k- ?rrnbh]shnm ne
tmbnmrbhntr q]bd ]mc rnbh]k bk]rr ah]r vhsg uhfmdssd,
a]rdc bkhmhb]k ]rrdrrldmsr ax ldchb]k rstcdmsr-
I?L? 1/00:2/5’8(9831fl40-
01- G]hcdq ?G* Rbgmdhcdq DA* Rqhq]l M* ds ]k-
Tmbnmrbhntr q]bd ]mc bk]rr ah]r9 Hsr ]rrnbh]shnm vhsg
cdbhrhnm l]jhmf ax sq]tl] ]mc ]btsd b]qd rtqfdnmr- I
Sq]tl] ?btsd B]qd Rtqf 1/03:66’2(93/8fl05-
02- G]hcdq ?G* Rbgmdhcdq DA* Rqhq]l M* ds ]k-
Tmbnmrbhntr q]bd ]mc bk]rr ah]rdr ]lnmf qdfhrsdqdc
mtqrdr9 Uhfmdssd,a]rdc rstcx trhmf hlokhbhs ]rrnbh],
shnm sdrshmf- I ?l Bnkk Rtqf 1/04:11/’5(90/66fl75-
03- Jqdrr G,F* ?kchmfsnm C* ?knm D* ds ]k- ? gnkhrshb ]o,
oqn]bg sn bgqnmhb o]hm l]m]fdldms sg]s hmunkudr ]kk
rs]jdgnkcdqr9 Bg]mfd hr mddcdc- Btqq Ldc Qdr Nohm
1/04:20’8(90632fl43-
04- Svxbqnrr ?* Pthmm Q* Kddf]]qc L* R]kudssh L*
Fnqcnm C- Hmsdqm]shnm]k ?rrnbh]shnm enq sgd Rstcx ne
O]hm , btqqhbtktl ntskhmd nm o]hm enq mtqrhmf- 1/07-
?u]hk]akd ]s9gssor9..vvv-h]ro,o]hm-nqf.Dctb]shnm.
BtqqhbtktlCds]hk-]row; HsdlMtladq¼1/41-
’]bdrrdc Itmd 10(
05- S]hs QB* Bgham]kk IS* J]k]tnj]k]mh C- Oqnuhcdq itcf,
ldmsr ne o]shdmsr hm o]hm9 Rddjhmf rxlosnl bdqs]hmsx-
O]hm Ldc 1//8:0/’0(900fl23-
06- Svhff NB* Axqmd CF- Sgd hmfitdmbd ne bnmsdwst]k
u]qh]akdr nm itcfldmsr ]ants o]shdmsr ]mc sgdhq o]hm-
O]hm Ldc 1/04:05’0(977fl87-
07- fl Ldkknsh QL* R]lnkrjx Cdjdk AF* B]qnrh E* ds ]k-
B]sdfnqhdr ne bnmfqtdmbd adsvddm hmo]shdms rdke,
qdonqsdc o]hm ]mc mtqrdr du]kt]shnm- Dtq I O]hm 1//8:
029881fl0///-
08- fl R]lnkrjx Cdjdk AF* Fnqh ?* U]r]qqh ?* Rnqdkk] LB*
Mhmn F* Ldknssh QL- Ldchb]k duhcdmbd hmfitdmbd nm
hmo]shdmsr ]mc mtqrdr o]hm q]shmfr ]fqddldms- O]hm
Qdr L]m]f 1/05:1/0598156425-
1/- Knqdmyh,Bhnkch E- Kdr qdoqdrdms]shnmr cdr fqntodr
cnlhm]msr ds cnlhmdr9 Bnkkdbshnmr ds ]fqdf]sr-
Fqdmnakd9 Oqdrrdr tmhudqrhs]hqdr cd Fqdmnakd: 1//1-
10- E]tk E* Dqcedkcdq D* Atbgmdq ?* K]mf ?F- F) Onvdq*
Udqrhnm 2-0-6 Xbnlotsdq oqnfq]l[- Fdql]mx9
Tmhudqrhs~]s Jhdk: 1/02-
11- ?ydudcn KE* Bnrs],Odqdhq] ?* Ldmcnmb”] K* Ch]r BB*
B]rsqn,Knodr IL- Dohcdlhnknfx ne bgqnmhb o]hm9 ?
onotk]shnm,a]rdc m]shnmvhcd rstcx nm hsr oqdu]kdmbd*
.oPma^
Pn ds Pi
bg]q]bsdqhrshbr ]mc ]rrnbh]sdc chr]ahkhsx hm Onqstf]k- I
O]hm- 1/01:02’7(9662fl72-
12- ?ydudcn KE* Bnrs],Odqdhq] ?* Ldmcnmb”] K* Ch]r BB*
B]rsqn,Knodr IL- Sgd dbnmnlhb hlo]bs ne bgqnmhb
o]hm9 ? m]shnmvhcd onotk]shnm,a]rdc bnrs,ne,hkkmdrr
rstcx hm Onqstf]k- Dtq I Gd]ksg Dbnm 1/05:06
’0(976fl87-
13- Aqdhuhj G* Bnkkdss A* Udms]eqhcc] U* Bngdm Q*
F]kk]bgdq C- Rtqudx ne bgqnmhb o]hm hm Dtqnod9
Oqdu]kdmbd* hlo]bs nm c]hkx khed* ]mc sqd]sldms- Dtq I
O]hm 1//5:0/’3(9176fl222-
14- Cd Qtccdqd K* Fntadqs K* Rsdudmr L* Vhkkh]lr
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?BCB* Bqnlady F- Chrbntmshmf o]hm hm sgd ]a,
rdmbd ne ldchb]k duhcdmbd hr dwok]hmdc ax mdf]shud
du]kt]shnm ne sgd o]shdms- O]hm 1/02:043
’4(9558fl65-
15- Cd Qtccdqd K* Fntadqs K* Rsdudmr L?K* Cdudtfdkd
L* Bq]hf JC* Bqnlady F- Gd]ksg b]qd oqnedrrhnm]kr&
qd]bshnmr sn o]shdms o]hm9 Hlo]bs ne jmnvkdcfd ]ants
ldchb]k duhcdmbd ]mc orxbgnrnbh]k hmfitdmbdr- I O]hm
1/03:04’2(9151fl6/-
16- L]qlns L- Rs]str rxmcqnld- Rhfmh“b]mbd 1//3:0
’3(904/fl3-
17- Adqm]qcdr R* Bnrs] L* B]qu]kgn G- Dmfdmcdqhmf o]hm
l]m]fdldms oq]bshbdr9 Sgd qnkd ne ogxrhbh]m rdw nm
bgqnmhb knv,a]bj o]hm ]rrdrrldms ]mc sqd]sldms oqd,
rbqhoshnmr- I O]hm 1/02:03’8(9820fl3/-
18- ?ckdq MD* Dodk DR* B]rsdkk]yyn F* Hbjnuhbr IQ-
Qdk]shnmrgho ne rtaidbshud ]mc naidbshud rnbh]k rs]str
vhsg orxbgnknfhb]k ]mc ogxrhnknfhb]k etmbshnmhmf9
Oqdkhlhm]qx c]s] hm gd]ksgx vghsd vnldm- Gd]ksg
Orxbgnk 1///:08’5(9475fl81-
2/- Cnqjhm QG* Stqj CB* E]qq]q IS* ds ]k- Bnqd ntsbnld
ld]rtqdr enq bgqnmhb o]hm bkhmhb]k sqh]kr9 HLLO?BS
qdbnlldmc]shnmr- O]hm 1//4:002’0fl1(98fl08-
20- Adqm]qcdr RE- Rnaqd ] Bnmsdwst]khc]cd cnr
Dmuhdr]ldmsnr cd Rdwn mnr Itkf]ldmsnr cd Cnq-
Khran]9 Etmc]b”^ ]n B]kntrsd Ftkadmjh]m: 1/0/-
21- L]bjv]x,Inmdr J* L]qrcdm I* Vhmckd I- Dldqfdmbx
Sqh]fd9 L]mbgdrsdq Sqh]fd Fqnto- Mdv Idqrdx9 Ingm
Vhkdx % Rnmr: 1/02- XBqnrrQde[
22- ?mcdqrnm JN* Fqddm BQ* O]xmd Q- Q]bh]k ]mc dsgmhb
chro]qhshdr hm o]hm9 B]trdr ]mc bnmrdptdmbdr ne tm,
dpt]k ]qd- I O]hm 1//8:0/’01(90076fl1/3-
23- Sq]v]ksdq R* Gneel]m JL* V]xsy ?- Q]bh]k ah]r hm
odqbdoshnmr ne nsgdqr& o]hm- OknR Nmd 1/01:6
’00(9d37435-
24- G]rk]l M- Cdgtl]mhy]shnm9 ?m hmsdfq]shud qduhdv-
Odqr Rnb Orxbgnk Qdu 1//5:0/’2(9141fl53-
25- Kntfgm]m R* G]rk]l M* Rtssnm QL* Rodmbdq A-
Cdgtl]mhy]shnm ]mc rnbh]k bk]rr9 ?mhl]khsx hm sgd
rsdqdnsxodr ne zvghsd sq]rg*† zbg]ur*† ]mc zanf]mr-†
Rnb Orxbgnk 1/03:34’0(943fl50-
26- K]lldqr I* Rs]odk C?- Onvdq hmbqd]rdr cdgtl]mhy],
shnm- Fqnto Oqnbdrr Hmsdqfqnto Qdk]s 1/00:03
’0(9002fl15-
BiPrrerl em CPem BPod
27- Tqh N* Dkh]r R* Adgqa]kj D* G]kodqm O- Mn fdmcdq,
qdk]sdc ah]r hm ]btsd ltrbtknrjdkds]k o]hm l]m]fd,
ldms hm sgd dldqfdmbx cdo]qsldms- Dldqf Ldc I
1/04:21’1(9038fl41-
28- Bgh]q]lnmsd FQ* Eqhdmc Q- Ldchb]k rstcdmsr& ]mc
qdrhcdmsr& fdmcdq ah]r hm sgd ch]fmnrhr* sqd]sldms* ]mc
hmsdqoqds]shnm ne bnqnm]qx gd]qs chrd]rd rxlosnlr-
Gd]ksg Orxbgnk 1//5:14’2(9144fl55-
3/- Jq]tr LV* O]qj IV* S]m II- Rhfmr ne rnbh]k bk]rr9
Sgd dwodqhdmbd ne dbnmnlhb hmdpt]khsx hm dudqxc]x
khed- Odqrodbs Orxbgnk Rbh 1/06:01’2(9311fl24-
10.4
30- Drbna]q IH* Qtahn,Rshodb L* B]mhmn F* J]qmn L-
Rnl]shb Rxlosnl Hmcdw ’RRH(9 ? mdv ]mc ]aqhcfdc
rnl]shy]shnm bnmrsqtbs9 Oqdu]kdmbd ]mc dohcdlhnknfh,
b]k bnqqdk]sdr hm svn k]qfd bnlltmhsx r]lokdr- I Mdqu
Ldms Chr 0878:066’2(903/fl5-
31- Ghqrg ?S* Gnkkhmfrgd]c M?* L]ssgh]r LR* A]hq LI*
Jqndmjd J- Sgd hmfitdmbd ne o]shdms rdw* oqnuhcdq rdw*
]mc rdwhrs ]sshstcdr nm o]hm sqd]sldms cdbhrhnmr- I
O]hm 1/03:04’4(9440fl8-
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