Tanabe Yutaka
Department of Anesthesiology, Juntendo University School of Medicine, Bunkyo ku, Tokyo.
Rinsho Byori. 2007 Mar;55(3):241-50.
The pain remaining after a needle stick is categorized as neuropathic pain. CRPS (Complex Regional Pain Syndrome) is a typical disease in this category. Neuropathic pain is extremely intractable when it becomes chronic pain, inducing psychological and physical pain in patients over a long period of time. Neuropathic pain is a complex system caused by various factors, and its mechanism remains unclear. For prevention, medical practioners should carefully select centesis, and apply necessary measures corresponding to the situation. There is no established treatment for neuropathic pain. We usually treat the disease with nerve block and drug therapy. Nerve block is useful for pain relief. We typically use a sympathetic nerve block (SGB; stellate ganglion block, IRSB; intravenous regional sympathetic block et. al.) as the initial treatment. In the stage of chronic pain, it is very important to improve patients' ADL (activity of daily living) and QOL (quality of life). If neuropathic pain is suspected, it is crucial to treat at an early stage. Therefore, it should be emphasized that when pain persists after a needle stick, the patient should immediately consult a pain clinician or an orthopedist.
针刺后残留的疼痛被归类为神经性疼痛。复杂性区域疼痛综合征(CRPS)是这类疾病中的典型病症。当神经性疼痛发展为慢性疼痛时,会极其难以治疗,长期给患者带来心理和身体上的痛苦。神经性疼痛是由多种因素导致的复杂系统,其发病机制尚不清楚。为预防起见,医生应谨慎选择穿刺操作,并根据具体情况采取必要措施。目前尚无针对神经性疼痛的确切治疗方法。我们通常采用神经阻滞和药物疗法来治疗该病。神经阻滞对缓解疼痛有效。我们通常将交感神经阻滞(SGB;星状神经节阻滞,IRSB;静脉区域交感神经阻滞等)作为初始治疗手段。在慢性疼痛阶段,改善患者的日常生活活动能力(ADL)和生活质量(QOL)非常重要。如果怀疑是神经性疼痛,尽早治疗至关重要。因此,应当强调的是,针刺后疼痛持续时,患者应立即咨询疼痛科医生或骨科医生。