"鼻膜性疼痛":对鼻科和知觉的挑战
Milton Cohen1, John Quintner2, Asaf Weisman3
1School of Clinical Medicine, UNSW Medicine & Health, St Vincent's Healthcare Clinical Campus, UNSW Sydney, Sydney, New South Wales, Australia.
The journal of pain
|July 23, 2023
概括
诺基普拉斯疼痛是一个有争议的概念. 调和观点需要重新定义感知,提出一个感知器械的经验测试和生物可信性.
科学领域:
- 疼痛研究和神经科学的研究.
- 临床鼻科和分类.
- 疼痛感知神经生理学 疼痛感知神经生理学
背景情况:
- "nociplastic疼痛"的概念引发了争议,有些人接受它,有些人拒绝它,因为没有 nociceptor激活.
- 现有的定义和分类,包括第11版国际疾病分类 (ICD-11),在适应这种构造方面面临挑战.
- 国际疼痛研究协会 (IASP) 对疼痛和痛感的定义是正在进行的辩论的核心.
研究的目的:
- 解剖关于脑膜疼痛的不同观点,并寻求和解.
- 为了澄清诺西普拉斯疼痛,原发性疼痛和中心敏感化之间的关系.
- 为了应对诺西普拉斯疼痛对 nociception 的定义及其与组织损伤的联系所带来的挑战.
主要方法:
- 概念分析和对现有文献和定义的批判性审查.
- 探索临床实用性和理论基础的nociplastic疼痛.
- 关于可视化概念的修订概念框架的建议.
主要成果:
- 鼻膜性疼痛,初级疼痛和中央敏感性代表着不同的领域,不应该混为一谈.
- 诺西普拉斯疼痛的构造,虽然需要轻微的修改和经验测试,但提供了临床合法性和实用性.
- 在nociplastic疼痛与IASP疼痛定义一致,但挑战目前的 nociception定义的情况下,存在一个局.
结论:
- 建议重新概念化 nociception,用"nociceptive装置"取代目前的定义.
- 这一修订后的概念允许对诺西普拉斯痛断言进行实证测试,并为疼痛提供了更具生物学可信性的基础.
- 拟议的变化旨在在理解疼痛机制和分类方面实现逻辑,生物学和临床的一致性.
相关概念视频
01:44Nociception
28.0K
Nociception—the ability to feel pain—is essential for an organism’s survival and overall well-being. Noxious stimuli such as piercing pain from a sharp object, heat from an open flame, or contact with corrosive chemicals are first detected by sensory receptors, called nociceptors, located on nerve endings. Nociceptors express ion channels that convert noxious stimuli into electrical signals. When these signals reach the brain via sensory neurons, they are perceived as pain.
28.0K
01:25Analgesia and Pain Management
661
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
661
01:20Pain
505
Pain serves as a critical warning signal that alerts the body to potential or actual harm. When mechanical pressure on the skin is intense, such as from a sharp pinch, the sensation transitions from touch to pain. Similarly, extreme temperatures, like a hot pot handle, convert the sensation of heat into pain. Pain can also result from overstimulation of other senses, such as blinding light, loud noise, or the intense heat from habañero peppers. This ability to sense pain is essential for...
505
01:24Local Anesthetics: Differential Sensitivity of Nerve Fibers
871
Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
871
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
338
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
338
01:29Blood and Nerve Supply to the Bones
11.2K
Bones are dynamic organs that require a rich supply of oxygen and nutrients. Around 5% to 10% of the cardiac output supplies blood to the bones. A typical long bone has three main sources: the nutrient artery, the metaphyseal and epiphyseal arteries, and the periosteal arteries.
Nutrient Artery
The nutrient artery is the main blood vessel that enters the diaphysis via the nutrient foramen. While most long bones have only one nutrient foramen, large bones, such as the femur, may have two. This...
Nutrient Artery
The nutrient artery is the main blood vessel that enters the diaphysis via the nutrient foramen. While most long bones have only one nutrient foramen, large bones, such as the femur, may have two. This...
11.2K