Gordon S M, Dionne R A
Pain and Neurosensory Mechanisms Branch, National Institute of Dental Research, National Institutes of Health, Bethesda, Maryland, USA.
Compend Contin Educ Dent. 1997 Mar;18(3):239-42, 244, 246 passim; quiz 252.
Pain is a multistep process originating in the peripheral nervous system at the site of injury, transmitted by the peripheral nervous system, processed at several levels within the central nervous system, and finally perceived at the level of the cerebral cortex. Each of these steps in pain transmission is subject to intervention, with the possibility of reducing or blocking the nociceptive information to result in decreased pain. In general, therapeutic strategies that attempt to prevent the initiation or transmission of nociceptive information are more effective and safer than attempts to minimize pain after it occurs. Analgesic strategies based on knowledge of pain processes and results of controlled clinical trials should result in the prevention of pain in most patients, with fewer adverse effects than traditional analgesic therapy.
疼痛是一个多步骤过程,始于损伤部位的周围神经系统,由周围神经系统传导,在中枢神经系统的多个层面进行处理,最终在大脑皮层层面被感知。疼痛传导的每一个步骤都可进行干预,有可能减少或阻断伤害性信息,从而减轻疼痛。一般来说,试图预防伤害性信息起始或传导的治疗策略比疼痛发生后试图减轻疼痛的策略更有效、更安全。基于疼痛过程知识和对照临床试验结果的镇痛策略应能在大多数患者中预防疼痛,且副作用比传统镇痛疗法更少。