Mather L E, Cousins M J
Department of Anaesthesia and Pain Management, University of Sydney, Royal North Shore Hospital, St Leonards, NSW.
Med J Aust. 1992 Jun 1;156(11):796-802. doi: 10.5694/j.1326-5377.1992.tb121567.x.
To provide a general description of the pharmacological principles of pain management particularly the management of severe pain with opioid analgetic agents.
Literature updating previous reviews by the authors in this Journal and the Proceedings of the VIth World Congress on Pain, Adelaide, 1-6 April 1990.
Studies were selected under the subheadings: opioid receptors; endogenous opioids; development of new agents; recognition of the need to improve analgesia; pharmacokinetics and pharmacodynamics of opioids; and novel drug delivery methods.
The extracted information was more descriptive than quantitative.
The pharmacological relief of pain involves treatment of patients with drugs characterised by extremely large interpatient variability in pharmacokinetics and pharmacodynamics by way of an extremely complex interaction with endogenous control mechanisms. It is not surprising that management of pain in many patients is less than adequate.
Although much vigorous interdisciplinary research is being undertaken to develop a scientific basis for understanding pain and analgesia, improvements in the clinical management of pain can only occur if practitioners recognise the need for individualised methods of pain relief and treat their patients accordingly.
对疼痛管理的药理学原理进行总体描述，尤其是使用阿片类镇痛药管理重度疼痛。
作者在本期刊发表的既往综述以及1990年4月1日至6日于阿德莱德召开的第六届世界疼痛大会会议记录的文献更新。
研究在以下副标题下进行选择：阿片受体；内源性阿片类物质；新型药物的研发；认识到改善镇痛效果的必要性；阿片类药物的药代动力学和药效学；以及新型给药方法。
提取的信息更多是描述性而非定量性的。
疼痛的药理学缓解涉及使用药物治疗患者，这些药物在药代动力学和药效学方面存在极大的个体间差异，通过与内源性控制机制的极其复杂的相互作用发挥作用。许多患者的疼痛管理不足也就不足为奇了。
尽管正在进行大量积极的跨学科研究以建立理解疼痛和镇痛的科学基础，但只有当从业者认识到需要采用个体化的疼痛缓解方法并相应地治疗患者时，疼痛的临床管理才能得到改善。
