Opioid administration following spinal cord injury: implications for pain and locomotor recovery.
Opioid administration following spinal cord injury: implications for pain and locomotor recovery.
复制标题
脊髓损伤后的阿片类药物给药：对疼痛和运动恢复的影响。
DOI：
10.1016/j.expneurol.2013.03.008
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发表时间：
2013-09
影响因子：
5.3
通讯作者：
Hook, Michelle A.
中科院分区：
文献类型：
--
作者：
Woller, Sarah A.;Hook, Michelle A.
关键词：
大约三分之一的脊髓损伤（SCI）患者在损伤后会经历持续的神经性疼痛。这种疼痛会对生活质量产生负面影响，而且很难治疗。阿片类药物是最有效的药物治疗之一，并且经常被处方，但实验证据表明，阿片类药物治疗在损伤的急性期会减弱运动功能的恢复。事实上，脊髓损伤和阿片类药物有几个共同的特征（如中枢致敏、兴奋毒性、神经胶质异常激活），这些特征与功能恢复受损以及疼痛的发生有关。尽管有这些影响，阿片类药物使用与脊髓损伤之间的相互作用尚未得到充分探讨。本文所述的文献综述表明，在脊髓损伤后使用阿片类药物是有必要的。阿片类药物可能协同促进脊髓损伤的病理发展，增加疼痛的发展，减少运动恢复，并使个体面临感染的风险。考虑到这些负面影响，重要的是制定脊髓和其他中枢神经系统损伤后阿片类药物使用指南。
Approximately one-third of people with a spinal cord injury (SCI) will experience persistent neuropathic pain following injury. This pain negatively affects quality of life and is difficult to treat. Opioids are among the most effective drug treatments, and are commonly prescribed, but experimental evidence suggests that opioid treatment in the acute phase of injury can attenuate recovery of locomotor function. In fact, spinal cord injury and opioid administration share several common features (e.g. central sensitization, excitotoxicity, aberrant glial activation) that have been linked to impaired recovery of function, as well as the development of pain. Despite these effects, the interactions between opioid use and spinal cord injury have not been fully explored. A review of the literature, described here, suggests that caution is warranted when administering opioids after SCI. Opioid administration may synergistically contribute to the pathology of SCI to increase the development of pain, decrease locomotor recovery, and leave individuals at risk for infection. Considering these negative implications, it is important that guidelines are established for the use of opioids following spinal cord and other central nervous system injuries.
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