Mechanism-based pain management in chronic pancreatitis – is it time for a paradigm shift?
| Autor: | Anne Estrup Olesen, Asbjørn Mohr Drewes, Søren Schou Olesen, Lars Arendt-Nielsen, Louise Kuhlmann |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
pain measurements Mechanism based Symptom assessment 030226 pharmacology & pharmacy Pain Measurements 03 medical and health sciences 0302 clinical medicine Pancreatitis Chronic Humans Medicine Pharmacology (medical) General Pharmacology Toxicology and Pharmaceutics Pain Measurement Analgesics symptom assessment business.industry Chronic pain Pain Perception Visceral pain General Medicine Pain management medicine.disease pain management 030220 oncology & carcinogenesis analgesics Physical therapy Pancreatitis Chronic Pain neurophysiology medicine.symptom chronic pain business Chronic pancreatitis |
| Zdroj: | Kuhlmann, L, Olesen, S S, Olesen, A E, Arendt-Nielsen, L & Drewes, A M 2019, ' Mechanism-based pain management in chronic pancreatitis-is it time for a paradigm shift? ', Expert Review of Clinical Pharmacology, vol. 12, no. 3, pp. 249-258 . https://doi.org/10.1080/17512433.2019.1571409 |
| ISSN: | 1751-2441 1751-2433 |
| DOI: | 10.1080/17512433.2019.1571409 |
| Popis: | Introduction: Pain is the most common symptom in chronic pancreatitis and treatment remains a challenge. Management of visceral pain, in general, is only sparsely documented, and treatment in the clinic is typically based on empirical knowledge from somatic pain conditions. This may be problematic, as many aspects of the neurobiology differ significantly from somatic pain, and organs such as the gut and liver play a major role in tolerability to analgesics. On the other hand, clinical awareness and new methods for quantitative assessment of pain mechanisms, will likely increase our understanding of the visceral pain system and guide more individualized pain management. Areas covered: This review includes an overview of known pain mechanisms in chronic pancreatitis and how to characterize them using quantitative sensory testing. The aim is to provide a mechanism-oriented approach to analgesic treatment, including treatment of psychological factors affecting pain perception and consideration of side effects in the management plan. Expert opinion: A mechanism-based examination and profiling of pain in chronic pancreatitis will enable investigators to provide a well-substantiated approach to effective management. This mechanism-based, individualized regime will pave the road to better pain relief and spare the patient from unnecessary trial-and-error approaches and unwanted side effects. |
| Databáze: | OpenAIRE |
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