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1. 成人における非がん性慢性疼痛管理へのアプローチapproach to the management of chronic non cancer pain in adults [show details]
… management of chronic non-cancer pain, and an overview of nonpharmacologic therapies. Pharmacologic management of chronic pain, and evaluation of chronic non-cancer pain are discussed separately. It …
2. 小児や青年の慢性腹痛：評価のためのアプローチchronic abdominal pain in children and adolescents approach to the evaluation [show details]
… Chronic abdominal pain is common in children and adolescents. The evaluation of the child or adolescent with chronic abdominal pain requires an understanding of the pathogenesis of abdominal pain, the most common …
3. 小児期に生じる股関節痛へのアプローチapproach to hip pain in childhood [show details]
…and secondary avascular necrosis of the hip include insidious onset of hip pain with limp and activity-related pain . The pain is not always relieved by rest or medication. Diagnosis of LCP demands a high …
4. 乳児および小児における急性周術期疼痛管理へのアプローチapproach to the management of acute perioperative pain in infants and children [show details]
… Pharmacologic options for perioperative pain management in these children are discussed separately. Evaluation and management of pain in neonates, and the effects of untreated pain in neonates, are discussed separately …
5. 急性疼痛患者への初めてのオピオイド鎮痛薬処方prescription of opioids for acute pain in opioid naive patients [show details]
… postoperative pain. In general, procedures and injuries that involve bones and joints are more painful than those that involve soft tissue . A number of studies have examined the degree of pain and/or the …

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関連記事	「疼痛」「不能」「象徴」

「疼痛」

　　[★]

英: pain, dolor
同: 痛み
関: 痛覚 pain sensation

疼痛

疼痛の伝達

Aδ線維
C線維

疼痛の調節

ゲートコントロール：Aδ線維とC線維による痛みはAβ線維による入力で中枢伝達細胞のレベルで抑制される。
下行性疼痛抑制系神経系：下行性疼痛抑制系神経系による入力で中枢伝達細胞のレベルで抑制される。

下行性疼痛抑制系神経系は中脳水道周辺灰白質からの脊髄への入力からなる。具体的には大縫線核(セロトニン作動性)、巨大細胞網様核・傍巨大細胞網様核(ノルアドレナリン作動性)がの2系統が起点となる。抗うつ薬はこれらの神経伝達物質の再吸収を妨げ鎮痛作用を発揮する。

痛みと異常知覚の命名法

Adams and s Principles of Neurology, Ninth Edition Allan Ropper. table 8-2より抜粋

dysesthesia : Any abnormal sensation described as unpleasant by the patient.
hyperalgesia : Exaggerated pain response from a normally painful stimulus; usually includes aspects of summation with repeated stimulus of constant intensity and aftersensation.
hyperpathia : Abnormally painful and exaggerated reaction to a painful stimulus; related to hyperalgesia.
hyperesthesia (hypesthesia) : Exaggerated perception of touch stimulus.
allodynia : Abnormal perception of pain from a normally nonpainful mechanical or thermal stimulus; usually has elements of delay in perception and of aftersensation.
hypoalgesia (hypalgesia) : Decreased sensitivity and raised threshoid to painful stimuli.
anesthesia : Reduced perception of all sensation, mainly touch.
pallanesthesia : Loss of perception of vibration.
analgesia : Reduced perception of pain stimulus.
paresthesia : Mainly spontaneous abnormal sensation that is not unpleasant; usually described as "pins and needles".
causalgia : Buming pain in the distribution of one or more peripheral nerves.