Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA, USA.
Medical College of Wisconsin, Wauwatosa, WI, USA.
Best Pract Res Clin Anaesthesiol. 2020 Sep;34(3):493-506. doi: 10.1016/j.bpa.2020.08.007. Epub 2020 Aug 8.
Chronic pain syndromes cost the US healthcare system over $600 billion per year. A subtype of chronic pain is neuropathic pain (NP), which is defined as "pain caused by a lesion or disease of the somatosensory system," according to the International Association for the Study of Pain (IASP). The pathophysiology of neuropathic pain is very complex, and more research needs to be done to find the exact mechanism. Patients that have preexisting conditions such as cancer and diabetes are at high-risk of developing NP. Many NP patients are misdiagnosed and receive delayed treatment due to a lack of a standardized classification system that allows clinicians to identify, understand, and utilize pain management in these patients. Medications like tricyclic antidepressants, serotonin-norepinephrine reuptake Inhibitor (SNRIs), and gabapentinoids are first-line treatments followed by opioids, cannabinoids, and other drugs. There are limited studies on the treatment of NP.
慢性疼痛综合征每年使美国医疗保健系统花费超过 6000 亿美元。根据国际疼痛研究协会 (IASP) 的定义，慢性疼痛的一个亚组是神经性疼痛 (NP)，它是“由躯体感觉系统的损伤或疾病引起的疼痛”。神经性疼痛的病理生理学非常复杂，需要进一步研究以找到确切的机制。患有癌症和糖尿病等先前存在的疾病的患者患 NP 的风险很高。由于缺乏标准化的分类系统，许多 NP 患者被误诊，并因未能及时治疗而延误，该系统可让临床医生识别、理解和利用这些患者的疼痛管理。三环类抗抑郁药、5-羟色胺去甲肾上腺素再摄取抑制剂 (SNRIs) 和加巴喷丁类药物等药物是一线治疗药物，随后是阿片类药物、大麻素和其他药物。关于 NP 的治疗方法的研究有限。
