Kent Michael L, Tighe Patrick J, Belfer Inna, Brennan Timothy J, Bruehl Stephen, Brummett Chad M, Buckenmaier Chester C, Buvanendran Asokumar, Cohen Robert I, Desjardins Paul, Edwards David, Fillingim Roger, Gewandter Jennifer, Gordon Debra B, Hurley Robert W, Kehlet Henrik, Loeser John D, Mackey Sean, McLean Samuel A, Polomano Rosemary, Rahman Siamak, Raja Srinivasa, Rowbotham Michael, Suresh Santhanam, Schachtel Bernard, Schreiber Kristin, Schumacher Mark, Stacey Brett, Stanos Steven, Todd Knox, Turk Dennis C, Weisman Steven J, Wu Christopher, Carr Daniel B, Dworkin Robert H, Terman Gregory
Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, Maryland.
Department of Anesthesiology, University of Florida, Gainesville, Florida.
J Pain. 2017 May;18(5):479-489. doi: 10.1016/j.jpain.2017.02.421.
With the increasing societal awareness of the prevalence and impact of acute pain, there is a need to develop an acute pain classification system that both reflects contemporary mechanistic insights and helps guide future research and treatment. Existing classifications of acute pain conditions are limiting, with a predominant focus on the sensory experience (eg, pain intensity) and pharmacologic consumption. Consequently, there is a need to more broadly characterize and classify the multidimensional experience of acute pain.
Consensus report following expert panel involving the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION), American Pain Society (APS), and American Academy of Pain Medicine (AAPM).
As a complement to a taxonomy recently developed for chronic pain, the ACTTION public-private partnership with the US Food and Drug Administration, the APS, and the AAPM convened a consensus meeting of experts to develop an acute pain taxonomy using prevailing evidence. Key issues pertaining to the distinct nature of acute pain are presented followed by the agreed-upon taxonomy. The ACTTION-APS-AAPM Acute Pain Taxonomy will include the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms. Future efforts will consist of working groups utilizing this taxonomy to develop diagnostic criteria for a comprehensive set of acute pain conditions.
The ACTTION-APS-AAPM Acute Pain Taxonomy (AAAPT) is a multidimensional acute pain classification system designed to classify acute pain along the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms.
Significant numbers of patients still suffer from significant acute pain, despite the advent of modern multimodal analgesic strategies. Mismanaged acute pain has a broad societal impact as significant numbers of patients may progress to suffer from chronic pain. An acute pain taxonomy provides a much-needed standardization of clinical diagnostic criteria, which benefits clinical care, research, education, and public policy. For the purposes of the present taxonomy, acute pain is considered to last up to seven days, with prolongation to 30 days being common. The current understanding of acute pain mechanisms poorly differentiates between acute and chronic pain and is often insufficient to distinguish among many types of acute pain conditions. Given the usefulness of the AAPT multidimensional framework, the AAAPT undertook a similar approach to organizing various acute pain conditions.
随着社会对急性疼痛的患病率和影响的认识不断提高，需要开发一种急性疼痛分类系统，既能反映当代的机制见解，又有助于指导未来的研究和治疗。现有的急性疼痛状况分类存在局限性，主要侧重于感觉体验（如疼痛强度）和药物使用情况。因此，有必要更广泛地描述和分类急性疼痛的多维体验。
这是一份由镇痛、麻醉与成瘾临床试验转化、创新、机遇与网络组织（ACTTION）、美国疼痛学会（APS）和美国疼痛医学学会（AAPM）的专家小组参与后形成的共识报告。
作为最近为慢性疼痛开发的分类法的补充，ACTTION与美国食品药品监督管理局、APS和AAPM的公私合作召集了一次专家共识会议，以利用现有证据制定急性疼痛分类法。文中先介绍了与急性疼痛独特性质相关的关键问题，随后给出了达成共识的分类法。ACTTION-APS-AAPM急性疼痛分类法将包括以下几个维度：1）核心标准，2）共同特征，3）调节因素，4）影响/功能后果，5）假定的病理生理疼痛机制。未来的工作将由工作组利用该分类法为一系列急性疼痛状况制定诊断标准。
ACTTION-APS-AAPM急性疼痛分类法（AAAPT）是一种多维急性疼痛分类系统，旨在沿以下维度对急性疼痛进行分类：1）核心标准，2）共同特征，3）调节因素，4）影响/功能后果，5）假定的病理生理疼痛机制。
尽管现代多模式镇痛策略已经出现，但仍有大量患者遭受严重的急性疼痛。急性疼痛管理不当会产生广泛的社会影响，因为大量患者可能会发展为慢性疼痛。急性疼痛分类法为临床诊断标准提供了急需的标准化，这对临床护理、研究、教育和公共政策都有益处。就目前的分类法而言，急性疼痛被认为持续时间最长可达七天，延长至30天也较为常见。目前对急性疼痛机制的理解难以很好地区分急性疼痛和慢性疼痛，而且往往不足以区分多种急性疼痛状况。鉴于AAPT多维框架的实用性，AAAPT采用了类似的方法来组织各种急性疼痛状况。
