Fuse Y, Fujita N
Dept. of Anesthesia, Saitama Cancer Center Hospital, Japan.
Gan To Kagaku Ryoho. 1992 Mar;19(3):286-93.
The accurate assessment of pain is essential in cancer pain treatment. As pain is a subjective experience, there is no precise method to quantitate it objectively. There are two approaches: the first is the use of laboratory techniques to measure the patient's reaction to experimental pain, such as sensory decision theory analysis. This method is a psychophysical procedure to distinguish between a person's criteria for reporting pain and the sensory experiences induced by noxious stimuli. The second is the use of tools to assess pain by the patient's description. Many kinds of rating scales, including visual analogue scales, have been used to evaluate the intensity of clinical pain, but they cannot assess the quality of pain. For the specification of both qualitative and quantitative properties of clinical pain, the McGill Pain Questionnaire (MPQ) was constructed using 102 words that patients use to describe pain. The sensitivity and usefulness of the MPQ are no longer in doubt, but it cannot be used in Japan as such because of the difference in cultural background and language. Listening carefully to the patient's complaint is required not only for the precise assessment of pain, but also is a form of psychological treatment. Cancer pain should be relieved as soon as possible. Although WHO cancer pain relief is the first choice, nerve blocks and intraoperative radiotherapy, if indicated, must be taken into consideration in the early phase of the pain treatment.
准确评估疼痛在癌症疼痛治疗中至关重要。由于疼痛是一种主观体验，目前尚无精确方法可客观量化它。有两种方法：第一种是使用实验室技术来测量患者对实验性疼痛的反应，比如感觉决策理论分析。此方法是一种心理物理学程序，用于区分个体报告疼痛的标准与有害刺激诱发的感觉体验。第二种是通过患者描述使用工具评估疼痛。包括视觉模拟量表在内的多种评定量表已被用于评估临床疼痛的强度，但它们无法评估疼痛的性质。为明确临床疼痛的定性和定量属性，麦吉尔疼痛问卷（MPQ）使用102个患者用于描述疼痛的词汇编制而成。MPQ的敏感性和实用性已毋庸置疑，但由于文化背景和语言差异，它在日本无法直接使用。仔细倾听患者的主诉不仅是精确评估疼痛所必需的，也是心理治疗的一种形式。癌症疼痛应尽快缓解。虽然世界卫生组织的癌症疼痛缓解方法是首选，但在疼痛治疗早期，如有指征，必须考虑神经阻滞和术中放疗。
