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1、PainShangrongLi,MDAnesthesiologydepartmentThirdhospitalSunYat-senUniversity2023/4/202ContentDefinitionsBasicofPainCategoriesandAssessmentMedicineNerveblockAcutepainChronicpain2023/4/203DefinitionofPainPainiswhatevertheexperiencingpersonsaysitis,existingwhenevertheexperiencingpers
2、onsaysitdoes.McCafferyM.(1968)2023/4/204“Painisanunpleasantsensoryandemotionalexperienceassociatedwithactualorpotentialtissuedamageordescribedintermsofsuchdamage.”IASP(1979)DefinitionofPainImpliesemotionalcomponentcanexistwithouttissuedamage.2023/4/205ContentDefinitionsBasicofPai
3、nTypeandAssessmentMedicineNerveblockAcutepainChronicpain2023/4/206TRPV辣椒素受体TREK钾离子通道ASIC酸敏感离子通道DRASICACIC3MDEG退化蛋白通道TRPM8冷受体82023/4/207Somatosensorynervefibers2023/4/208SomatosensorynervefibersFibertypeFibercharacteristicsSpeedofconductionAssociatedwithAβLarge,myelinated30-70m/se
4、cMechanicalstimuliAδSmall,myelinated12-30m/secCold,fastpain,mechanicalstimuliCSmall,unmyelinated0.5-2m/secSlow,heat,cold,mechanicalstimuli2023/4/2092023/4/20102023/4/2011PainPathways2023/4/2012ContentDefinitionsBasicofPainCategoriesandAssessmentMedicineNerveblockAcutepainChronicp
5、ain2023/4/2013CategoriesofPainSomaticpainExamples:acutepostoperativepain,bonefracturesaching,gnawing,and/orsharpinquality,welllocalizedinitiatedbynociceptoractivationincutaneousanddeeptissues.VisceralpainExamples:abdominalpainduetoconstipationdullandachinginqualityandpoorlylocali
6、zedassociatedwithtissueinjury,specificallyinfiltration,compression,anddistentionofviscera..Neuropathicpainexamples:trigeminalneuralgia，postherpeticneuralgia(PHN)shooting,electrical,orburningpainoftenissuperimposedonachronicbackgroundofburningandachingsensations.resultsfrominjuryt
7、otheperipheralorCNS.2023/4/2014Trigeminalneuralgia2023/4/2015AcuteorChronicAcutepain:Canberesolvedquickly,lessthan3-6monthsHighlycorrelatedtodamageExample:Postoperativepain,BonefractureChronicpain:lastlongtime,morethan3-6months“painthatextendsbeyondtheexpectedperiodofhealing”Aris
8、efrominju
