Bushnell Timothy G, Justins Douglas M
Pain Management Centre, St Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, England.
Drugs. 1993 Sep;46(3):394-408. doi: 10.2165/00003495-199346030-00006.
Pain is an unpleasant sensory and emotional experience, unique to each individual patient. In the dynamic processes of nociceptive stimulation, signal transmission, central decoding and interpretation there are many potential sites for pharmacological intervention, and there are many drugs which will produce analgesia. An analgesic 'ladder' has been proposed for rational pain relief in cancer and a similar concept should be used in all forms of acute and chronic pain. Continuing research and drug development undoubtedly extends our understanding, but consistent improvement in our clinical ability to relieve pain depends more on our willingness to consider the need of each patient individually, to tailor the drug, route and mode of administration to that patient's requirements, and then to monitor on the basis of the response of the patient to the treatment.
疼痛是一种不愉快的感觉和情感体验，每个患者感受各异。在伤害性刺激、信号传递、中枢解码与阐释的动态过程中，存在诸多药物干预的潜在靶点，且有多种药物可产生镇痛效果。针对癌症疼痛的合理缓解已提出了一个镇痛“阶梯”，所有急慢性疼痛形式都应采用类似概念。持续的研究与药物研发无疑拓展了我们的认知，但我们临床缓解疼痛能力的持续提升，更多地取决于我们是否愿意单独考虑每个患者的需求，根据患者的要求调整药物、给药途径和给药方式，然后根据患者对治疗的反应进行监测。
