The Anatomy of Pain and Its Implications for Regional Anesthesiology Practice

摘要: In years past, the prevailing approach to providing pain control was focused on identifying underlying etiologies or pathologic syndromes, e.g., low back pain, trigeminal neuralgia, and cancer that produce pain. While treating presumed source of attempts improve accompanying discomfort relied largely use non-opioid medications limited opioid adjuvant analgesics. Over past 25 years, however, there has been a dramatic increase in our understanding nervous system how stimuli associated with actual potential tissue injury are transduced, transmitted, modulated, perceived, interpreted form basis for initiating appropriate evasive protective behavior, thereby avoiding limiting injury. Our current bank knowledge led recognition (1) chronic state is itself disease deserving consideration, assessment, management; (2) not single entity but complex, multifaceted experience warrants detailed comprehensive evaluation elucidate symptoms may reflect specific mechanisms amenable targeted treatment (Woolf Decosterd, Pain 6(Suppl), S141–7, 1999; Woolf Max, Anesthesiology 95, 241–9, 2001); (3) modalities management approaches heretofore considered can be effective quality life those suffering This chapter will provide brief overview anatomy forms practice.