Assessment and management of pain/nociception in patients with disorders of consciousness or locked-in syndrome: A narrative review.

IF 3.1 4区医学 Q2 NEUROSCIENCES

Frontiers in Systems Neuroscience Pub Date : 2023-01-01 DOI:10.3389/fnsys.2023.1112206

Estelle A C Bonin, Nicolas Lejeune, Emilie Szymkowicz, Vincent Bonhomme, Charlotte Martial, Olivia Gosseries, Steven Laureys, Aurore Thibaut

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引用次数: 2

Abstract

The assessment and management of pain and nociception is very challenging in patients unable to communicate functionally such as patients with disorders of consciousness (DoC) or in locked-in syndrome (LIS). In a clinical setting, the detection of signs of pain and nociception by the medical staff is therefore essential for the wellbeing and management of these patients. However, there is still a lot unknown and a lack of clear guidelines regarding the assessment, management and treatment of pain and nociception in these populations. The purpose of this narrative review is to examine the current knowledge regarding this issue by covering different topics such as: the neurophysiology of pain and nociception (in healthy subjects and patients), the source and impact of nociception and pain in DoC and LIS and, finally, the assessment and treatment of pain and nociception in these populations. In this review we will also give possible research directions that could help to improve the management of this specific population of severely brain damaged patients.

Abstract Image

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意识障碍或闭锁综合征患者疼痛/伤害感觉的评估和管理:一篇叙述性综述。

对于意识障碍(DoC)或闭锁综合征(LIS)等无法沟通的患者，疼痛和伤害感觉的评估和管理是非常有挑战性的。因此，在临床环境中，医务人员检测疼痛和伤害感的迹象对这些患者的健康和管理至关重要。然而，在这些人群中，关于疼痛和伤害感受的评估、管理和治疗，仍有许多未知和缺乏明确的指导方针。这篇叙述性综述的目的是通过涵盖不同的主题来检查当前关于这一问题的知识，例如:疼痛和伤害感觉的神经生理学(在健康受试者和患者中)，DoC和LIS中伤害感觉和疼痛的来源和影响，最后，这些人群中疼痛和伤害感觉的评估和治疗。在这篇综述中，我们也将给出可能的研究方向，以帮助改善对这一特定人群的严重脑损伤患者的管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Systems Neuroscience Neuroscience-Developmental Neuroscience

CiteScore

6.00

自引率

3.30%

发文量

144

审稿时长

14 weeks

期刊介绍： Frontiers in Systems Neuroscience publishes rigorously peer-reviewed research that advances our understanding of whole systems of the brain, including those involved in sensation, movement, learning and memory, attention, reward, decision-making, reasoning, executive functions, and emotions.