O'Gorman David A, Raja Srinivasa N
Division of Pain Medicine, Anesthesiology, and Critical Care Medicine, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287-5354, USA.
Curr Pain Headache Rep. 2002 Dec;6(6):452-9. doi: 10.1007/s11916-002-0064-z.
Diagnostic infusion therapy has several advantages over other routes of drug administration in the management of chronic pain. Although systemic side effects may occur, the procedure is relatively noninvasive and is generally well tolerated by patients. Infusion techniques have a potential use in the blinded evaluation of a patient's response to a specific therapy, and thus may minimize placebo responses associated with the more invasive diagnostic nerve blocks. Infusion tests may be useful prognostic indicators of the potential efficacy of a class of oral drugs in a patient. This article reviews the scientific and clinical background behind the major classes of drugs used in diagnostic infusion testing, namely local anesthetics, opioids, and a-adrenergic blockers. Clinical application of these agents in the management of chronic pain also is outlined.
在慢性疼痛管理中，诊断性输注疗法相较于其他给药途径具有若干优势。尽管可能会出现全身性副作用，但该 procedure 相对无创，且患者通常耐受性良好。输注技术在对患者对特定疗法的反应进行盲法评估中具有潜在用途，因此可将与侵入性更强的诊断性神经阻滞相关的安慰剂反应降至最低。输注试验可能是某类口服药物对患者潜在疗效的有用预后指标。本文回顾了诊断性输注试验中使用的主要药物类别背后的科学和临床背景，即局部麻醉药、阿片类药物和α-肾上腺素能阻滞剂。还概述了这些药物在慢性疼痛管理中的临床应用。
