Institute for Pain Medicine, Rambam Health Campus, Haifa, Israel; Ruth and Bruce Rapaport Faculty of Medicine, Technion, Haifa, Israel.
Center for Translational Pain Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts.
Anesthesiology. 2022 Jul 1;137(1):93-108. doi: 10.1097/ALN.0000000000004204.
The gut microbiome plays critical roles in human health and disease. Recent studies suggest it may also be associated with chronic pain and postoperative pain outcomes. In animal models, the composition of the gut microbiome changes after general anesthesia and affects the host response to medications, including anesthetics and opioids. In humans, the gut microbiome is associated with the development of postoperative pain and neurocognitive disorders. Additionally, the composition of the gut microbiome has been associated with pain conditions including visceral pain, nociplastic pain, complex regional pain syndrome, and headaches, partly through altered concentration of circulating bacterial-derived metabolites. Furthermore, animal studies demonstrate the critical role of the gut microbiome in neuropathic pain via immunomodulatory mechanisms. This article reviews basic concepts of the human gut microbiome and its interactions with the host and provide a comprehensive overview of the evidence linking the gut microbiome to anesthesiology, critical care, and pain medicine.
肠道微生物组在人类健康和疾病中发挥着关键作用。最近的研究表明，它也可能与慢性疼痛和术后疼痛结果有关。在动物模型中，肠道微生物组的组成在全身麻醉后发生变化，并影响宿主对药物的反应，包括麻醉剂和阿片类药物。在人类中，肠道微生物组与术后疼痛和神经认知障碍的发展有关。此外，肠道微生物组的组成与疼痛状况有关，包括内脏疼痛、神经性疼痛、复杂性区域疼痛综合征和头痛，部分原因是循环细菌衍生代谢物的浓度发生了变化。此外，动物研究表明，肠道微生物组通过免疫调节机制在神经病理性疼痛中起着关键作用。本文综述了人类肠道微生物组的基本概念及其与宿主的相互作用，并全面概述了将肠道微生物组与麻醉学、重症监护和疼痛医学联系起来的证据。
