Chelsea and Westminster NHS Foundation Trust, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital Campus, London, UK.
National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
Anaesthesia. 2015 Jul;70(7):828-47. doi: 10.1111/anae.13018. Epub 2015 Mar 14.
Pain diagnosis and management would benefit from the development of objective markers of nociception and pain. Current research addressing this issue has focused on five main strategies, each with its own advantages and disadvantages. These encompass: (i) monitoring changes in the autonomic nervous system; (ii) biopotentials; (iii) neuroimaging; (iv) biological (bio-) markers; and (v) composite algorithms. Although each strategy has shown areas of promise, there are currently no validated objective markers of nociception or pain that can be recommended for clinical use. This article introduces the most important developments in the field and highlights shortcomings, with the aim of allowing the reader to make informed decisions about what trends to watch in the future.
疼痛的诊断和管理将受益于对伤害感受和疼痛的客观标记物的开发。目前针对这一问题的研究主要集中在五个主要策略上,每个策略都有其自身的优缺点。这些策略包括:(i)监测自主神经系统的变化;(ii)生物电位;(iii)神经影像学;(iv)生物(bio-)标记物;和(v)组合算法。尽管每种策略都显示出了一定的前景,但目前还没有可以推荐用于临床的疼痛或伤害感受的验证性客观标记物。本文介绍了该领域最重要的进展,并强调了其不足之处,旨在使读者能够就未来需要关注的趋势做出明智的决策。