烧伤患者的神经病痛 - 一个很少文献的常见问题: 一个系统的审查
Eloise Stanton1, Paul Won1, Artur Manasyan2
1Keck School of Medicine of USC, Los Angeles, CA, USA; Division of Plastic and Reconstructive Surgery, Keck Medicine of USC, Los Angeles, CA, USA.
概括
神经病痛 (NP) 影响高达80%的烧伤患者. 本综述强调了关于NP的原因和治疗方法的有限证据,呼吁进行更多的研究以改善患者的治疗结果.
科学领域:
- 疼痛管理 疼痛管理
- 烧伤手术 烧伤手术
- 神经学 神经学
背景情况:
- 神经病痛 (NP) 在烧伤幸存者中非常普遍,影响到80%的人口.
- 烧伤患者中NP的复杂性需要对当前的管理策略进行全面审查.
研究的目的:
- 系统地审查有关烧伤患者神经病痛发病率,风险因素和管理的文献.
- 总结当前的理解,并确定有关NP在这个群体的证据的差距.
主要方法:
- 按照PRISMA指南进行了一次系统的文献审查.
- 在包括PubMed,Cochrane,Embase,Scopus,Ovid和Web of Science在内的主要数据库中进行了搜索.
- 主要结果包括NP发生率和管理;次要结果关注风险因素.
主要成果:
- 来自11个国家的研究涉及4366名患者,确定了诸如老年,药物滥用,吸烟,较大的烧伤表面积和长时间住院等危险因素.
- 研究的药理疗法包括 gabapentinoids,阿斯科布酸和利多卡因,报告的疗效不同.
- 非药物干预措施,如电疗法,电穿刺,神经重建和康复,在减少疼痛和改善功能方面显示出有前途.
结论:
- 目前关于NP病理生理学,风险因素和烧伤患者治疗疗效的证据仍然不足.
- 进一步的前性和随机研究对于开发基于证据的NP管理协议至关重要.
- 改善对NP的理解和治疗可以显著提高烧伤幸存者的生活质量和功能恢复.
相关概念视频
01:22Burn Injuries
2.5K
Burn injuries occur when the skin and underlying tissues are damaged due to exposure to heat, electricity, chemicals, radiation, or friction. They can vary in severity, from minor superficial burns to severe deep burns that can be life-threatening.
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
2.5K
01:25Analgesia and Pain Management
618
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...
618
01:20Pain
478
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...
478
01:44Nociception
27.9K
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.
27.9K