Viel E, Estève M, Draussin G, Eledjam J J
Département d'Anesthésie-Réanimation, Centre Hospitalier Universitaire, Nîmes.
Cah Anesthesiol. 1995;43(6):565-71.
Deafferentation syndromes have in common the existence of a physical injury and/or of a functional impairment of a nerve, either somatosensory afferent (Phantom Limb Pain) and/or sympathetic efferent (Reflex Sympathetic Dystrophy). These progressively debilitating syndromes are the witness of the absence of self-limitation of neuronal sensitization, which is normally the evolution of any painful stimulation of spinal cord neurons. To some extent deafferentation syndromes could be defined as a maladaptive neuronal plasticity. The lack of complete understanding of underlying pathophysiological mechanisms gives account of the wide variety of proposed treatments and of their unpredictable and variable efficacy. This fact is also due in part to the lack of controlled studies of most of the therapeutic propositions, whose purported efficacy is usually based on anecdotal reports. Finally, the role of prevention must be strongly emphasized, focusing, if those syndromes are likely to occur following surgery, on the importance of pre- and postoperative efficient analgesia, and also, possibly, on the preemptive role of regional anaesthetic techniques.
去传入综合征的共同特点是存在神经的物理损伤和/或功能障碍，无论是躯体感觉传入神经（幻肢痛）和/或交感传出神经（反射性交感神经营养不良）。这些逐渐使人衰弱的综合征表明神经元致敏缺乏自我限制，而这在正常情况下是脊髓神经元任何疼痛刺激的演变过程。在某种程度上，去传入综合征可被定义为一种适应不良的神经元可塑性。对潜在病理生理机制缺乏全面了解，导致了各种治疗方法的提出以及它们不可预测和多变的疗效。这一事实部分也是由于大多数治疗方法缺乏对照研究，其声称的疗效通常基于轶事报道。最后，必须大力强调预防的作用，如果这些综合征可能在手术后发生，应关注术前和术后有效镇痛的重要性，也可能要关注区域麻醉技术的先发作用。
