《2008八年制讲稿修改1》.ppt

Diagnosis and treatment  of Pain Introduction Introduction Intruduction ◆ Every person may experience pain at some time, in some extent, for some reason. ◆ Pain is one of the most important part of our sensation, which warn us of kinds of injuries/risks so that we can avoid or deal with these injuries/risks. ◆ Pain also cause us unpleasant feeling, influence on our physiological function and life quality, even threat on our lives. This make pain an important problem to be treated clinically. ◆ It is necessary for us medical students to have a good understanding of pain. Intruduction 每一个人生命过程中会由于不同原因在不同时期不同程度受到疼痛的折磨，严重时会影响生理机能和生命质量，甚至危及生命安全。有的时候疼痛本身就是一种病（如三叉神经痛），或者引起疼痛的原发疾病已不那么重要（如晚期癌痛），使疼痛治疗成为唯一的选择 The development of pain management The development of pain management 在埃及、 印度等国很早就采用大麻、罂栗碱、曼陀罗(mandala, stramonium)等止痛 在巴比伦用莨菪果实(scopola) 等制成粘土胶涂于 龋齿止痛 在希腊和罗马用鸦片制剂缓解关节痛和胸痛 古代秘鲁土人用古卡叶涂于伤口止 痛 The development of pain management 1654,Pare,local analgesia with press 1611,Katz,local analgesia with opioid ointment 1844, Well,N2O for tooth extraction pain 1946, Serverino, local analgesia with ice 1947,Simpson,labor pain control with halothane 1884,Koller,topical anesthesia with cocaine 1899,Bier,spinal anesthesia 1912,Harris,trigeminal neuralgia injection。 1931,Dogliotti,long-term analgesia for cancer patients by subarachnoid absolute alcohol The development of pain management 1936,E.A.Rovenstine, nerve block clinic 1961,Bonica,pain clinic 1962, 山村秀夫《麻醉科门诊》 1965,《疼痛研究会》 1966,《疼痛临床杂志》 1975,佛洛伦萨,1st IASP 1976, 若杉文吉,疼痛科 1982，Milan,cancer pain conference 1984,《疼痛研究会》改为《日本疼痛学会》 1985,鹿特丹,疼痛临床国际学术交流会and《Pain clnic》 The development of pain management Thousands of pain management unit Tens of pain related journals Hundreds thousands of members Advance in the field of pain Basic research More targeting,less toxic drugs PCA Microinvasive techniques The history of pain management Definition of Pain pain as an unpleasant sensory and emotional experience associated