Donovan M
Nurs Clin North Am. 1982 Dec;17(4):713-28.
Pain exists because electrical impulses travel along a series of nerves from "where it hurts" through the gate in the spinal cord and through the thalamus to the areas of the brain where thinking, feeling, and action are controlled. Along this path are several "switches" that can adjust the pain, or turn it down as one would the volume of a radio. Figure 5 summarizes the interventions that have been discussed in this article in relation to these four switches. One can use a moderate to large amount of a single intervention (such as medication) to shut off the pain; or one can use small to moderate amounts of a combination of interventions to accomplish the same or greater level of comfort. In most situations, a combined approach provides the patient with better control of pain, a more active role in his care, fewer side effects, and less dependence on others.
疼痛的存在是因为电脉冲沿着一系列神经从“疼痛部位”通过脊髓中的“闸门”，再经过丘脑，传至大脑中控制思维、感觉和行动的区域。在这条路径上有几个“开关”，它们可以调节疼痛，或者像调节收音机音量一样将疼痛减轻。图5总结了本文中讨论的与这四个“开关”相关的干预措施。人们可以使用适量至大量的单一干预措施（如药物治疗）来消除疼痛；或者可以使用少量至适量的多种干预措施组合来达到相同或更高程度的舒适感。在大多数情况下，综合治疗方法能让患者更好地控制疼痛，在自身护理中发挥更积极的作用，减少副作用，并减少对他人的依赖。
