Paltved C V, Kamp-Jensen M, Højsted J, Eriksen J
Kirurgisk gastroenterologisk afdeling D, Amtssygehuset i Gentofte.
Ugeskr Laeger. 1999 Mar 22;161(12):1739-43.
Neuropathic pain is caused by lesions in the peripheral and/or central nervous system. Patients with pain due to nerve damage after operations are often misinterpreted and met with suspicion of malingering. Neuropathic pain typically presents with a characteristic set of sensory disorders independent of the cause. The sensory dysfunction may manifest itself as hypo- and/or hyperesthesia to one or more modalities, increased pain to painful stimuli (hyperalgesia) and/or pain to non-painful stimuli (allodynia). Conventional analgesics such as acetaminophen, non-steroidal anti-inflammatory drugs and opioids are often ineffective. Instead, antidepressants and anticonvulsants may be tried. The pain condition is unknown to most physicians. This may result in mistreated patients having undergone several unnecessary and ineffective investigations and treatments.
神经性疼痛由外周和/或中枢神经系统损伤引起。手术后因神经损伤而疼痛的患者常被误解,并被怀疑是在装病。神经性疼痛通常表现出一组独立于病因的特征性感觉障碍。感觉功能障碍可能表现为对一种或多种感觉方式的感觉减退和/或感觉过敏、对疼痛刺激的疼痛加剧(痛觉过敏)和/或对非疼痛刺激的疼痛(感觉异常)。对乙酰氨基酚、非甾体抗炎药和阿片类等传统镇痛药往往无效。相反,可以尝试使用抗抑郁药和抗惊厥药。大多数医生对这种疼痛状况并不了解。这可能导致患者接受了几次不必要且无效的检查和治疗。