Reuler J B, Girard D E, Nardone D A
Ann Intern Med. 1980 Oct;93(4):588-96. doi: 10.7326/0003-4819-93-4-588.
The management of chronic pain is a universal and vexing problem for physicians. Literature indicates that health care providers have a poor understanding of basic concepts relating to pain, which leads to frustration for the physician and inadequate relief for the patient. This paper addresses misconceptions about organic versus functional pain, discusses placebos and administration of narcotic analgesics, and outlines therapeutic alternatives. Emphasis is on distinguishing chronic pain of benign origin from that secondary to malignancy as an individual treatment plan is formulated.
慢性疼痛的管理对医生来说是一个普遍且棘手的问题。文献表明,医疗保健提供者对与疼痛相关的基本概念理解不足,这给医生带来了挫败感,也使患者无法得到充分的疼痛缓解。本文探讨了关于器质性疼痛与功能性疼痛的误解,讨论了安慰剂和麻醉性镇痛药的使用,并概述了治疗选择。重点是在制定个体化治疗方案时,区分良性起源的慢性疼痛与继发于恶性肿瘤的慢性疼痛。