Department of Anesthesiology, University of Michigan Health System, Ann Arbor, Michigan, USA.
Curr Opin Anaesthesiol. 2011 Oct;24(5):532-9. doi: 10.1097/ACO.0b013e32834a1091.
The present review is intended to give an overview of fibromyalgia for the anesthesiologist. While the basics of the treatment of fibromyalgia are included, the intent is to provide context to discuss the potential implications in perioperative management.
Research continues to demonstrate that fibromyalgia patients have neurophysiologic abnormalities that alter sensory perception, including lower levels of central neurotransmitters associated with the inhibition of pain and higher levels those that facilitate pain. While comorbid mood disorders are more common in fibromyalgia patients, studies have shown that fibromyalgia symptoms are not explained by depression alone. In the last year, the American College of Rheumatology established a new self-report questionnaire for the diagnosis of fibromyalgia in lieu of the previously required tender point examination plus self-report questionnaire. This questionnaire allows for the study of the severity of sensitivity and symptomatology on a continuum, which is termed 'fibromyalgianess'. Some new concepts in the treatment have been proposed, including sodium oxybate, transcranial magnetic stimulation, and web-based cognitive behavioral therapy.
The impact of fibromyalgia on anesthesia care is not known. Years of quality research have clearly demonstrated multiple pathophysiologic changes that could impact anesthesia care and future study is needed.
本文旨在为麻醉医师概述纤维肌痛。虽然包括纤维肌痛治疗的基础知识，但目的是提供背景信息以讨论围手术期管理的潜在影响。
研究继续表明，纤维肌痛患者存在改变感觉感知的神经生理异常，包括与疼痛抑制相关的中枢神经递质水平降低和促进疼痛的水平升高。虽然纤维肌痛患者更常伴有情绪障碍，但研究表明，抑郁不能单独解释纤维肌痛症状。在过去的一年中，美国风湿病学会建立了一种新的纤维肌痛自我报告问卷，以替代以前必需的压痛点检查加自我报告问卷。该问卷允许对敏感性和症状学的严重程度进行连续研究，这被称为“纤维肌痛样”。一些新的治疗概念已经提出，包括羟丁酸钠、经颅磁刺激和基于网络的认知行为疗法。
纤维肌痛对麻醉护理的影响尚不清楚。多年的高质量研究清楚地表明了多种可能影响麻醉护理的病理生理变化，需要进一步研究。
