Markman John D, Philip Annie
Neuromedicine Pain Management Center, Department of Neurosurgery and Neurology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box 670 Rochester, New York 14642, USA.
Anesthesiol Clin. 2007 Dec;25(4):883-98, viii. doi: 10.1016/j.anclin.2007.07.012.
This article reviews the evidence for several common interventional techniques for the treatment of chronic pain, including: intraspinal delivery of analgesics, reversible blockade with local anesthetics, augmentation with spinal cord stimulation, and ablation with radiofrequency energy or neurolytic agents. The role of these techniques is defined within the framework of a multidisciplinary approach to the neurobehavioral syndrome of chronic pain. Challenges to the study of the analgesic efficacy of procedural interventions are explored, as are the practical issues raised by their clinical implementation, with the aim of helping nonspecialist physicians identify the patients most likely to benefit from these approaches.
本文综述了几种治疗慢性疼痛的常见介入技术的证据，包括：椎管内给予镇痛药、局部麻醉药的可逆性阻滞、脊髓刺激增强以及射频能量或神经溶解剂消融。这些技术的作用在慢性疼痛神经行为综合征的多学科方法框架内得以界定。探讨了程序性干预镇痛效果研究面临的挑战以及临床实施中出现的实际问题，目的是帮助非专科医生识别最有可能从这些方法中获益的患者。
