Visceral pain

IF 0.3 Q4 ANESTHESIOLOGY

Anaesthesia and Intensive Care Medicine Pub Date : 2025-05-15 DOI:10.1016/j.mpaic.2025.04.001

Iain Mactier, Tammar Al-Ani

{"title":"Visceral pain","authors":"Iain Mactier, Tammar Al-Ani","doi":"10.1016/j.mpaic.2025.04.001","DOIUrl":null,"url":null,"abstract":"<div><div>Visceral pain is a complex and multifaceted experience, distinct from somatic pain due to its diffuse localisation, autonomic involvement, and strong affective components. It arises from internal organs and follows unique neurophysiological pathways, encompassing transduction, transmission, perception, modulation, and amplification. Visceral nociception is transmitted via autonomic afferents and ascends through the spinothalamic, spinoreticular, spinomesencephalic, and dorsal column pathways. The extensive convergence of visceral and somatic afferents contributes to referred pain and poses diagnostic challenges. Acute visceral pain is primarily nociceptive, triggered by inflammation, ischaemia, or distension, whereas chronic visceral pain involves central sensitisation, dysfunction of descending modulation, and neuroimmune activation, leading to persistent pain and visceral hypersensitivity. While simple analgesics, opioids, and regional anaesthesia techniques incorporating sympathetic blockade remain cornerstones of acute visceral pain treatment, chronic visceral pain management is more complex. It relies on a multidisciplinary approach, integrating pharmacotherapy, interventional techniques, physiotherapy, psychotherapy, lifestyle modifications, and patient education to support self-management, improve symptom control, and enhance function and quality of life.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"26 7","pages":"Pages 420-425"},"PeriodicalIF":0.3000,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anaesthesia and Intensive Care Medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1472029925000682","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Visceral pain is a complex and multifaceted experience, distinct from somatic pain due to its diffuse localisation, autonomic involvement, and strong affective components. It arises from internal organs and follows unique neurophysiological pathways, encompassing transduction, transmission, perception, modulation, and amplification. Visceral nociception is transmitted via autonomic afferents and ascends through the spinothalamic, spinoreticular, spinomesencephalic, and dorsal column pathways. The extensive convergence of visceral and somatic afferents contributes to referred pain and poses diagnostic challenges. Acute visceral pain is primarily nociceptive, triggered by inflammation, ischaemia, or distension, whereas chronic visceral pain involves central sensitisation, dysfunction of descending modulation, and neuroimmune activation, leading to persistent pain and visceral hypersensitivity. While simple analgesics, opioids, and regional anaesthesia techniques incorporating sympathetic blockade remain cornerstones of acute visceral pain treatment, chronic visceral pain management is more complex. It relies on a multidisciplinary approach, integrating pharmacotherapy, interventional techniques, physiotherapy, psychotherapy, lifestyle modifications, and patient education to support self-management, improve symptom control, and enhance function and quality of life.

查看原文本刊更多论文

发自内心的痛苦

内脏疼痛是一种复杂的、多方面的体验，不同于躯体疼痛，因为它的弥漫性定位、自主神经参与和强烈的情感成分。它起源于内脏，遵循独特的神经生理途径，包括转导、传递、感知、调节和放大。内脏伤害感觉通过自主神经传入，并通过丘脑、神经网状、脑脊髓和背柱通路上升。内脏和躯体传入的广泛收敛有助于转诊疼痛，并提出诊断挑战。急性内脏痛主要是伤害性的，由炎症、缺血或肿胀引起，而慢性内脏痛涉及中枢致敏、下行调节功能障碍和神经免疫激活，导致持续疼痛和内脏超敏反应。虽然简单的镇痛药、阿片类药物和结合交感阻滞的局部麻醉技术仍然是急性内脏痛治疗的基础，但慢性内脏痛的治疗更为复杂。它依靠多学科方法，整合药物治疗、介入技术、物理治疗、心理治疗、生活方式改变和患者教育，以支持自我管理，改善症状控制，增强功能和生活质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Anaesthesia and Intensive Care Medicine ANESTHESIOLOGY-

CiteScore

0.50

自引率

0.00%

发文量

152

期刊介绍： Anaesthesia and Intensive Care Medicine, an invaluable source of up-to-date information, with the curriculum of both the Primary and Final FRCA examinations covered over a three-year cycle. Published monthly this ever-updating text book will be an invaluable source for both trainee and experienced anaesthetists. The enthusiastic editorial board, under the guidance of two eminent and experienced series editors, ensures Anaesthesia and Intensive Care Medicine covers all the key topics in a comprehensive and authoritative manner. Articles now include learning objectives and eash issue features MCQs, facilitating self-directed learning and enabling readers at all levels to test their knowledge. Each issue is divided between basic scientific and clinical sections. The basic science articles include anatomy, physiology, pharmacology, physics and clinical measurement, while the clinical sections cover anaesthetic agents and techniques, assessment and perioperative management. Further sections cover audit, trials, statistics, ethical and legal medicine, and the management of acute and chronic pain.