神経因性疼痛発症メカニズムと治療

• 山本 達郎

  熊本大学大学院医学薬学研究部生体機能制御学 熊本大学医学部附属病院麻酔科

書誌事項

タイトル別名

• Mechanisms of the development of neuropathic pain and its treatment

抄録

Neuropathic pain has been known to be refractory to traditional analgesics, such as opioids and nonsteroidal anti-inflammatoy drugs. Some mechanisms of the development of neuropathic pain have been proposed; 1) sprouting of A β fibers to the superficial layer of the dorsal horn, 2) ectopic discharge in the dorsal root ganglion and/or in neuroma at the nerve stump, 3) spinal sensitization. Ectopic discharge has been reported to be inhibited by Na+ channel blocker, such as lidocaine, and anticonvulsant. Lidocaine and anticonvulsant are used in the management of neuropathic pain. Activation of NMDA receptor is usually involved in the development of spinal sensitization and NMDA receptor antagonist, such as ketamine, is used in the management of neuropathic pain. Recently, α2δ subunit blocker, new class of anticonvulsant, is introduced to the management of neuropathic pain. α2δ subunit is the subunit of Ca²⁺ channel and modulate the influx of Ca²⁺. This Ca²⁺ influx induces release of neurotransmitter in the neuron. α2δ subunit blockers, such as gabapentin and pregabalin, may reduce the release of neurotransmitter and elicit analgesic effect in the treatment of neuropathic pain.

収録刊行物

• 日本ハンセン病学会雑誌

  日本ハンセン病学会雑誌 77 (3), 215-218, 2008

  日本ハンセン病学会

キーワード

• ガバペンチン
• 発芽
• 麻薬系鎮痛薬
• α2δサブユニット
• NMDA受容体

詳細情報

• CRID: 1390282681298240512
• NII論文ID: 10021952388
• NII書誌ID: AN10559906
• DOI: 10.5025/hansen.77.215
• ISSN: 1884314X
• ISSN: 13423681
• PubMed: 18800643
• Web Site: https://search.jamas.or.jp/link/ui/2008306961
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • Crossref
  • PubMed
  • CiNii Articles
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