截肢后慢性疼痛:异质现象的病理生理学和预防选择
Alexander B Stone1, Markus W Hollmann2, Lotte E Terwindt2
1Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Current opinion in anaesthesiology
|August 8, 2023
概括
预防慢性截肢后疼痛 (cPAP) 是至关重要的,但没有确定的治疗方案. 研究探讨了风险因素和新的干预措施,如神经调节用于幻肢疼痛管理.
科学领域:
- 神经科学是一个神经科学.
- 疼痛管理 疼痛管理
- 手术创新 在外科创新.
背景情况:
- 慢性截肢后疼痛 (cPAP) 是一个重大的临床挑战.
- 目前的策略强调预防,因为治疗困难.
- 目前还没有建立出一种普遍有效的基于证据的预防方案.
研究的目的:
- 审查目前对预防慢性截肢后疼痛的理解和新兴策略.
- 为了确定风险因素,并评估新的干预措施,幻肢疼痛.
主要方法:
- 对幻肢疼痛发展的建议风险因素的审查.
- 对众多止痛预防干预措施的评估.
- 探索新的技术,包括神经调节和冷.
- 评估诸如神经再植入等手术方法.
主要成果:
- 有许多止痛预防干预措施,但没有一个是最终的.
- 神经调节和冷是新兴的技术.
- 手术重新植入受伤的神经可能会减少幻肢疼痛的发生率.
结论:
- 幻肢疼痛是由于与患者特定因素相互作用的复杂的外周和中枢神经系统变化造成的.
- 由于治疗的挑战,预防至关重要.
- 需要进一步研究基于证据的干预措施,最佳时间和个性化预防的患者分层.
相关概念视频
Peripheral Artery Disease V: Postoperative Nursing Management
12
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
12
Peripheral Artery Disease IV: Nursing Management
12
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
12
Peripheral Artery Disease III: Interprofessional Care
11
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
11
Analgesia and Pain Management
657
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...
657
Nociception
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
Chronic Pancreatitis II: Collaborative Care
113
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
113


