Adler R
Schweiz Med Wochenschr. 1978 Mar 25;108(12):456-61.
A pain may seem to resist all kinds of therapy without necessarily being absolutely refractory to treatment. The factors are discussed which may contribute to the "refractoriness" of a pain to therapy in the area of pain due to carcinoma, i.e. lack of understanding of modern pain concepts, inability to diagnose pain as due to conversion, failure to recognize the influence of the affects anxiety, hopelessness etc. on pain intensity, administration of analgesics in situations where another form of therapy would be indicated, e.g. plexus blockade, and insufficient knowledge of the effects, side effects, dosage and timing of the administration of mild analgesics, neuroleptics, antidepressives and narcotics.
一种疼痛可能看似对各种治疗均有抵抗，但不一定是绝对无法治疗。本文讨论了在癌症所致疼痛领域中，可能导致疼痛对治疗“难治性”的因素，即对现代疼痛概念缺乏理解、无法诊断出转换性疼痛、未认识到情感（焦虑、绝望等）对疼痛强度的影响、在应采用其他治疗形式（如神经丛阻滞）的情况下给予镇痛药，以及对轻度镇痛药、抗精神病药、抗抑郁药和麻醉药的效果、副作用、剂量和给药时间了解不足。
