Overview of Neuropathic Pain after Abdominal Surgery

腹部手術後之神經性疼痛綜論

何天輝(Thien-Fiew Ho) ； 鄭宇哲(Yu-Che Cheng) ； 林秀立(Hsiu-Li Lin) ； 潘志遠(Chih-Yuan Pan)

《疼痛醫學雜誌》 19卷2期 (2009/09) Pp. 76-85

https://doi.org/10.29792/TTJP.200909.0004

摘要

術後疼痛可分為正常組織被破壞引起的疼痛性刺激和神經損傷引起的神經性疼痛。術後疼痛的嚴重度，有四種預測因子已被確認：先行存在之疼痛、焦慮狀態、年齡和手術類別。術後神經性疼痛的臨床特徵是在手術部位及周圍區域出現自發性或動作誘發之疼痛。近來術後急性神經性疼痛已漸受重視。診斷流程包含詳盡的醫療病史，著重於疼痛與該次或過往手術之相關性，以及生理和神經學評估。處理腹部手術之急性和慢性術後神經性疼痛仍然是一個困難之課題。及早確認預測因子，術中和術後提高警覺性，皆能確保較有效之疼痛處理。

關鍵字

疼痛 ； 腹部手術 ； 術後疼痛 ； 神經性疼痛

並列摘要

The postoperative pain might arise from noxious stimuli brought by damage to normal tissue or neuropathic pain caused by nerve injury.
Four important predictive factors for the intensity of postsurgical pain are identified: preexisting pain, anxiety, age and type of surgery. The clinical features of post-surgical neuropathic pain present spontaneous resting and movement provoked pain at the site of surgery and in the surrounding tissues. Recently it is emphasized on the development of neuropathic pain acutely after surgery. The diagnostic work-up for post-surgical neuropathic pain should comprise comprehensive medical history emphasizing the pain and its association with recent or remote surgery, physical examination, and neurological examinations. Acute and chronic post-surgical neuropathic pain remains difficult to cope with after abdominal surgery. Early identification of the predictive factors, increasing awareness during and after abdominal surgery provide more efficacious pain management.

並列關鍵字

Pain ； abdominal surgery ； post-surgical pain ； neuropathic pain