Abstract:
:The term "chronic" is often used in daily clinical practice to indicate a type of pain that lasts over time and is accompanied by diagnostic and therapeutic difficulties. The common feeling is that in this category are actually collected many different clinical cases with the unique characteristic that the pain lasts a long time. It follows that treatment failures are common and patients roam from doctor to doctor in search of an effective care program. At the same time the health spending for the treatment of these patients is becoming increasingly high. In clinical practice we meet many patients with obscure pain syndromes which are classified as "chronic" and untreatable only because persist for long time and that obtain a complete pain relief after a right diagnosis and a specific treatment. In this review the Authors want to argue that the term chronic should not be used only when the pain persists for some time or just when signs and symptoms of mechanisms in the central nervous systems are present. The authors suggest that there is a clear difference between acute and chronic pain but also that in chronic pain patients there are three different painful conditions: 1) patients with a chronic disease (or sequelae) and with chronic pain in which the pain mechanisms are closely related to the underlying chronic disease (e.g., rheumatoid arthritis) or to previous injury that has generated other unsolvable mechanisms (e.g., deafferentation pain after plexus avulsion); 2) patients with a chronic disease and chronic pain in which new mechanisms overlap those related to the underlying disease; 3) patients with chronic pain in whom the correlation between pain and the initial tissue injury is lost and the persistence of pain is due to new developed mechanisms. According to this classification we can distinguish patients with "painful chronic disease" by patients with "independent chronic pain". In these latter cases the complexity of the clinical picture is to be found in a maladaptative response to pain, in emergence of central nervous system mechanisms and in behavioral changes that, in turn, can cause long-term social, psychological and physical sequelae. Differences among patients in developing chronic pain can be related to differences in the ability of the brain to continuously adapt its functional and structural organization. It is obvious that the care plan for these complex patients is profoundly different from that needed for patients with pain linked to a chronic disease or stabilized pain mechanisms. The purpose of the present article is to provide a review of the most noteworthy developments in this field and to propose some observations that may help to understand this pain condition and the patients.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Bonezzi C,Demartini L,Buonocore Msubject
Has Abstractpub_date
2012-06-01 00:00:00pages
704-11issue
6eissn
0375-9393issn
1827-1596pii
R02127474journal_volume
78pub_type
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1991-06-01 00:00:00
abstract::Cardiac surgery patients often develop a restrictive pulmonary impairment and gas exchange abnormalities in the early postoperative period. Chest physiotherapy is routinely prescribed in order to reduce or prevent these complications. Besides early mobilization, positioning and shoulder girdle exercises, various breat...
journal_title:Minerva anestesiologica
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
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更新日期:1992-11-01 00:00:00
abstract::The authors describe a case of prolonged neuromuscular blockade following suxamethonlum in a patient with a normal cholinesterase activity and dibucaine number > or = 75%. In this case a peripheral nerve stimulator and capnography allowed neuromuscular blockade evaluation and fresh frozen plasma infusion led to a norm...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
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更新日期:1995-01-01 00:00:00
abstract::Anaesthesia with atracurium, fentanyl, and continuous intravenous infusion of propofol in two myasthenic patients is described. There were no intra and postoperative problems and operative conditions were considered excellent. This technique offers a safe alternative to inhalational anaesthesia for patients with myast...
journal_title:Minerva anestesiologica
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更新日期:1992-03-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
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更新日期:2005-07-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract:AIM:The aim of this study was to evaluate and compare the parameters for mechanical respiration in pediatric patients undergoing controlled ventilation with a laryngeal mask (LM) and an uncuffed orotracheal tube. METHODS:The study examined 100 ASA 1 patients undergoing general anesthesia with myoresolution and mechani...
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doi:
更新日期:2000-01-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2000-06-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2011-02-01 00:00:00
abstract::Anaesthetic management in asthmatic patients has been focused on avoiding bronchoconstriction and inducing bronchodilation. However, the definition of asthma has changed over the past decade. Asthma has been defined as a clinical syndrome characterized by an inflammatory process that extends beyond the central airways...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2007-06-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1996-05-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1999-10-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2002-11-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1998-10-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2009-04-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2007-03-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2016-07-01 00:00:00
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doi:
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journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1995-05-01 00:00:00
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更新日期:2014-06-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1989-01-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1999-09-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2002-07-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2003-12-01 00:00:00
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pub_type: 临床试验,杂志文章,多中心研究
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更新日期:2012-03-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2010-01-01 00:00:00
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更新日期:2015-12-01 00:00:00
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pub_type: 杂志文章
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