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急诊环境中的神经性疼痛:诊断与管理

Neuropathic Pain in the Emergency Setting: Diagnosis and Management.

作者信息

Doneddu Pietro Emiliano, Pensato Umberto, Iorfida Alessandra, Alberti Claudia, Nobile-Orazio Eduardo, Fabbri Andrea, Voza Antonio

机构信息

Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, MI, Italy.

Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, MI, Italy.

出版信息

J Clin Med. 2023 Sep 18;12(18):6028. doi: 10.3390/jcm12186028.

Abstract

Neuropathic pain, traditionally considered a chronic condition, is increasingly encountered in the emergency department (ED), accounting for approximately 20% of patients presenting with pain. Understanding the physiology and key clinical presentations of neuropathic pain is crucial for ED physicians to provide optimal treatment. While diagnosing neuropathic pain can be challenging, emphasis should be placed on obtaining a comprehensive medical history and conducting a thorough clinical examination. Patients often describe neuropathic pain as a burning or shock-like sensation, leading them to seek care in the ED after ineffective relief from common analgesics such as paracetamol and NSAIDs. Collaboration between emergency medicine specialists, neurologists, and pain management experts can contribute to the development of evidence-based guidelines specifically tailored for the emergency department setting. This article provides a concise overview of the common clinical manifestations of neuropathic pain that may prompt patients to seek emergency care.

摘要

神经性疼痛传统上被认为是一种慢性疾病,在急诊科(ED)越来越常见,约占疼痛就诊患者的20%。了解神经性疼痛的生理机制和关键临床表现对于急诊科医生提供最佳治疗至关重要。虽然诊断神经性疼痛具有挑战性,但应着重获取全面的病史并进行彻底的临床检查。患者常将神经性疼痛描述为灼痛或电击样感觉,在对扑热息痛和非甾体抗炎药等常用镇痛药无效后前往急诊科就诊。急诊医学专家、神经科医生和疼痛管理专家之间的合作有助于制定专门针对急诊科环境的循证指南。本文简要概述了可能促使患者寻求急诊治疗的神经性疼痛的常见临床表现。

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本文引用的文献

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Advances in the treatment of neuropathic pain.神经病理性疼痛治疗的进展。
Curr Opin Neurol. 2021 Oct 1;34(5):631-637. doi: 10.1097/WCO.0000000000000980.
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Pract Neurol. 2021 Oct;21(5):392-402. doi: 10.1136/practneurol-2020-002782. Epub 2021 Jun 9.

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