重新出现的疼痛
John D Loeser1, Jane C Ballantyne2
1Departments of Neurological Surgery and Anesthesiology and Pain Medicine.
The Clinical journal of pain
|May 16, 2024
概括
疼痛管理需要现代化. 区分外围疼痛和中心疼痛对于有效治疗至关重要,每种类型都需要不同的诊断和治疗策略.
科学领域:
- 疼痛医学 医学 疼痛医学
- 神经学 神经学
- 医学教育 医学教育
背景情况:
- 近50年来,疼痛患者的管理一直落后于预期.
- 目前的方法可能无法充分解决慢性疼痛疾病的复杂性.
- 国际疼痛研究协会 (IASP) 的框架需要重新评估.
研究的目的:
- 确定阻碍疼痛患者管理发展的因素.
- 重新审视疼痛分类和诊断的基本概念.
- 评估疼痛医生的当前教育和培训.
主要方法:
- 进行了对现有文献的全面审查.
- 专注于用于诊断和管理高影响性慢性疼痛的新策略.
- 分析疼痛医学中的概念框架.
主要成果:
- 传统的急性-慢性疼痛二分法不再被认为是有用的.
- 疼痛应根据来源进行分类:边缘或中央处理错误.
- 外围和中心疼痛综合征需要不同的诊断和治疗方法.
结论:
- 对外围疼痛有效的治疗方法,包括阿片类药物,对中心疼痛无效.
- 中心疼痛需要神经中心的治疗策略,避免专注于外围原因.
- 疼痛医生教育必须不断发展,为临床医生提供两种疼痛类型的技能.
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