From the Department of Plastic and Reconstructive Surgery, Ohio State University Wexner Medical Center.
Plast Reconstr Surg. 2020 Mar;145(3):629e-636e. doi: 10.1097/PRS.0000000000006559.
Pain is an unpleasant experience resulting from either tissue damage or insults to the somatosensory system. Approaches to pain management evolve as we better understand both pain pathways and the tools available to interrupt these. The interest surrounding botulinum neurotoxin as a chemodenervating agent has expanded to include its potential applications in painful pathologies, both within and beyond the confines of plastic surgery. In this article, the authors discuss botulinum neurotoxin's mechanism of action as it pertains to both muscular paralysis and its interplay in the modulation of proinflammatory pain mediators. In addition, the authors review evidence supporting the use of botulinum neurotoxin in common painful conditions, in order to prepare the readership to aptly provide their patients with evidence-based recommendations. After reading this article, the participant should be able to discuss both mechanism of action and common applications of botulinum neurotoxin in painful conditions.
疼痛是一种不愉快的体验，源于组织损伤或躯体感觉系统的损伤。随着我们对疼痛通路的更好理解以及可用于阻断这些通路的工具的增加，疼痛管理方法也在不断发展。肉毒毒素作为一种化学去神经药物的应用兴趣已经扩大，包括其在疼痛性病理中的潜在应用，不仅限于整形手术的范围之内。在本文中，作者讨论了肉毒毒素的作用机制，包括肌肉瘫痪及其在调节促炎疼痛介质中的相互作用。此外，作者还回顾了支持肉毒毒素在常见疼痛病症中应用的证据，以便为读者提供基于证据的建议。阅读本文后，参与者应该能够讨论肉毒毒素在疼痛病症中的作用机制和常见应用。
