治疗运动员神经病痛的药物考虑因素
Sina Ramtin1, Asif Ilyas2,3
1Rothman Orthopaedics, Philadelphia, USA. sina.ramtin@rothmanopioid.org.
International orthopaedics
|February 12, 2025
概括
运动员的神经病痛需要仔细的诊断和管理,平衡缓解疼痛与性能和世界反兴奋剂协会法规. 治疗重点是使用抗药和抗抑郁药等药物,避免使用禁止物质.
科学领域:
- 神经学 神经学
- 运动医学 运动医学
- 疼痛管理 疼痛管理
背景情况:
- 神经病痛源于神经损伤后的异常体感处理.
- 诊断包括临床病史,感官检查以及EMG,NCS和MRI等测试.
- 由于心理因素和运动引起的变化,运动员面临着独特的挑战.
研究的目的:
- 总结运动员神经病痛的诊断和管理.
- 突出运动群体疼痛评估和治疗方面的挑战.
- 强调药物符合世界反兴奋剂机构 (WADA) 的规定.
主要方法:
- 对神经病痛的诊断方法的审查.
- 对药理疗法的分析,重点关注运动员的具体考虑.
- 检查与神经病痛疼痛管理相关的WADA禁止物质.
主要成果:
- 运动员的神经病痛可能是由于神经被困,手术或受伤引起的.
- 药理选择包括抗药和抗抑郁药,并谨慎管理副作用.
- 严格遵守WADA规则至关重要,因为麻醉剂,大麻素和某些葡萄皮质激素的使用在比赛中被禁止.
结论:
- 在运动员中有效的神经病痛管理需要双重方法:疼痛控制和性能维护.
- 医疗保健提供者必须在考虑WADA合规的情况下进行复杂的治疗决策.
- 个性化治疗计划对于平衡治疗需求与反兴奋剂规则至关重要.
相关概念视频
Analgesia and Pain Management
429
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...
429
Nociception
27.7K
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.
27.7K
Opioid Analgesics: Synthetic and Semisynthetic Opioids
210
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...
210
Opioid Analgesics: Morphine and Other Natural Cogeners
167
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
167
Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions
386
Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
Although all competitive neuromuscular blockers are designed...
Although all competitive neuromuscular blockers are designed...
386
Skeletal Muscle Relaxants: Therapeutic Uses
462
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
462


