Department of Anesthesiology and Critical Care Medicine, Division of Pain Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, Rochester, New York, and Department of Neurology, Center for Human Experimental Therapeutics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Pain Med. 2021 Mar 18;22(3):616-636. doi: 10.1093/pm/pnaa407.
Acute neuropathic pain is a significant diagnostic challenge, and it is closely related to our understanding of both acute pain and neuropathic pain. Diagnostic criteria for acute neuropathic pain should reflect our mechanistic understanding and provide a framework for research on and treatment of these complex pain conditions.
The Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) public-private partnership with the U.S. Food and Drug Administration (FDA), the American Pain Society (APS), and the American Academy of Pain Medicine (AAPM) collaborated to develop the ACTTION-APS-AAPM Pain Taxonomy (AAAPT) for acute pain. A working group of experts in research and clinical management of neuropathic pain was convened. Group members used literature review and expert opinion to develop diagnostic criteria for acute neuropathic pain, as well as three specific examples of acute neuropathic pain conditions, using the five dimensions of the AAAPT classification of acute pain.
AAAPT diagnostic criteria for acute neuropathic pain are presented. Application of these criteria to three specific conditions (pain related to herpes zoster, chemotherapy, and limb amputation) illustrates the spectrum of acute neuropathic pain and highlights unique features of each condition.
The proposed AAAPT diagnostic criteria for acute neuropathic pain can be applied to various acute neuropathic pain conditions. Both the general and condition-specific criteria may guide future research, assessment, and management of acute neuropathic pain.
急性神经病理性疼痛是一个重大的诊断挑战,它与我们对急性疼痛和神经病理性疼痛的理解密切相关。急性神经病理性疼痛的诊断标准应反映我们的机制理解,并为这些复杂疼痛状况的研究和治疗提供一个框架。
止痛、麻醉和成瘾临床试验转化、创新、机遇和网络(ACTION)与美国食品和药物管理局(FDA)、美国疼痛学会(APS)和美国疼痛医学学院(AAPM)的公私合作伙伴关系合作制定了急性疼痛的 ACTION-APS-AAPM 疼痛分类法(AAAPT)。召集了一个神经病理性疼痛研究和临床管理方面的专家工作组。小组成员使用文献回顾和专家意见制定了急性神经病理性疼痛的诊断标准,以及三种特定的急性神经病理性疼痛状况,使用 AAAPT 急性疼痛分类的五个维度。
提出了急性神经病理性疼痛的 AAAPT 诊断标准。将这些标准应用于三种特定情况(与带状疱疹、化疗和肢体截肢相关的疼痛)说明了急性神经病理性疼痛的范围,并突出了每种情况的独特特征。
拟议的 AAAPT 急性神经病理性疼痛诊断标准可应用于各种急性神经病理性疼痛状况。一般和具体情况的标准都可以指导未来对急性神经病理性疼痛的研究、评估和管理。