Castroman Pablo, Quiroga Ovelio, Mayoral Rojals Victor, Gómez Maria, Moka Eleni, Pergolizzi Joseph, Varrassi Giustino
Anesthesiology, University of Montevideo, Montevideo, URY.
Pain Medicine, Clinica del Dolor, Coquimbo, CHL.
Cureus. 2022 Apr 9;14(4):e23992. doi: 10.7759/cureus.23992. eCollection 2022 Apr.
Acute pain may be influenced by biopsychosocial factors. Conditioned pain modulation, distraction, peripheral nerve stimulation, and cryoneurolysis may be helpful in its treatment. New developments in opioids, such as opioids with bifunctional targets and oliceridine, may be particularly suited for acute pain care. Allosteric modulators can enhance receptor subtype selectivity, offering analgesia with fewer and/or less severe side effects. Neuroinflammation in acute pain is caused by direct insult to the central nervous system and is distinct from neuroinflammation in degenerative disorders. Pharmacologic agents targeting the neuroinflammatory process are limited at this time. Postoperative pain is a prevalent form of acute pain and must be recognized as a global public health challenge. This type of pain may be severe, impede rehabilitation, and is often under-treated. A subset of surgical patients develops chronic postsurgical pain. Acute pain is not just temporally limited pain that often resolves on its own. It is an important subject for further research as acute pain may transition into more damaging and debilitating chronic pain. Reimagining how we treat acute pain will help us better address this urgent unmet medical need.
急性疼痛可能受生物心理社会因素影响。条件性疼痛调制、分散注意力、周围神经刺激和冷冻神经溶解术可能有助于其治疗。阿片类药物的新进展，如具有双功能靶点的阿片类药物和奥利替丁，可能特别适用于急性疼痛护理。变构调节剂可增强受体亚型选择性，提供副作用更少和/或更轻的镇痛效果。急性疼痛中的神经炎症是由中枢神经系统直接损伤引起的，与退行性疾病中的神经炎症不同。目前针对神经炎症过程的药物制剂有限。术后疼痛是急性疼痛的一种常见形式，必须被视为一项全球公共卫生挑战。这类疼痛可能很严重，会阻碍康复，且往往治疗不足。一部分手术患者会发展为慢性术后疼痛。急性疼痛并非仅仅是通常会自行缓解的暂时受限疼痛。它是一个有待进一步研究的重要课题，因为急性疼痛可能会转变为更具破坏性和使人衰弱的慢性疼痛。重新思考我们治疗急性疼痛的方式将有助于我们更好地应对这一迫切的未满足医疗需求。
