Kapural Leonardo, Jolly Suneil
Carolinas Pain Institute, Winston-Salem, NC, 27103, USA.
Curr Treat Options Gastroenterol. 2016 Sep;14(3):360-70. doi: 10.1007/s11938-016-0100-4.
Treatment of persistent pain from chronic pancreatitis historically was difficult to treat. For years, focus was on opioid and other analgesics and psychological treatments. Recent studies provided evidence for decrease in analgesic intake and pain scores after properly conducted sympathetic blocks (celiac, splanchnic nerve blocks). These therapies should be considered as parts of a multimodal analgesic strategy. Animal studies suggest that spinal cord stimulation suppresses visceral hyperalgesia. Large case series of spinal cord stimulation demonstrated a significant pain relief in patients with chronic pancreatitis. Given the limitations of conservative and surgical treatments for chronic visceral pain, spinal cord stimulation may be a very useful therapeutic option.
从历史上看，慢性胰腺炎所致持续性疼痛的治疗一直很困难。多年来，重点一直放在阿片类药物和其他镇痛药以及心理治疗上。最近的研究为在正确实施交感神经阻滞（腹腔神经丛、内脏神经阻滞）后镇痛药摄入量和疼痛评分的降低提供了证据。这些疗法应被视为多模式镇痛策略的一部分。动物研究表明，脊髓刺激可抑制内脏痛觉过敏。大量脊髓刺激病例系列证明，慢性胰腺炎患者的疼痛得到了显著缓解。鉴于慢性内脏痛保守治疗和手术治疗的局限性，脊髓刺激可能是一种非常有用的治疗选择。
