Artigo dor

7818 palavras 32 páginas
British Journal of Anaesthesia 101 (1): 8– (2008) 16

doi:10.1093/bja/aen088 Advance Access publication April 15, 2008

REVIEW ARTICLES Spinal cord mechanisms of pain
R. D’Mello* and A. H. Dickenson
Department of Pharmacology, University College London, Gower Street, London WC1E 6BT, UK
*Corresponding author. E-mail: r.d’mello@ucl.ac.uk
The spinal cord is the first relay site in the transmission of nociceptive information from the periphery to the brain. Sensory signals are transmitted from the periphery by primary afferent fibres into the dorsal horn of the spinal cord, where these afferents synapse with intrinsic spinal dorsal horn neurones. Spinal projection neurones then convey this information to higher centres in the brain, where non-noxious and noxious signals can be perceived. During nociceptive transmission, the output of the spinal cord is dependent on various spinal mechanisms which can either increase or decrease the activity of dorsal horn neurones. Such mechanisms include local excitatory and inhibitory interneurones, N-methyl-D-aspartate receptor activation, and descending influences from the brainstem, which can be both inhibitory and excitatory in nature. After nerve injury or conditions of inflammation, shifts can occur in these excitatory and inhibitory mechanisms which modulate spinal excitability, often resulting in the heightened response of dorsal neurones to incoming afferent signals, and increased output to the brain, a phenomenon known as central sensitization. In this review, we consider the ways in which spinal cord activity may be altered in chronic pain states. In addition, we discuss the spinal mechanisms which are targeted by current analgesics used in the management of chronic pain. Br J Anaesth 2008; 101: 8 –16 Keywords: analgesics non-opioid; pain; spinal cord

Downloaded from http://bja.oxfordjournals.org/ at Universidade Federal do Rio de Janeiro on March 29, 2012

According to the International Association for the Study

Relacionados

  • Artigo Manejo Da Dor
    3005 palavras | 13 páginas
  • artigo psicofisiologia da dor
    7518 palavras | 31 páginas
  • Resumo artigo "A dor" de Berlinck
    331 palavras | 2 páginas
  • Artigo De Dor Tor Cica
    3961 palavras | 16 páginas
  • Artigo Cientifico Anatomia - Dor Patelo Femoral
    6591 palavras | 27 páginas
  • A Dor no Doente Oncológico
    6555 palavras | 27 páginas
  • Funcionamento de ferramentas de virtualizacao
    9197 palavras | 37 páginas
  • Avaliação Psicológica de paciente com dor crônica
    3185 palavras | 13 páginas
  • tcc fisio
    3322 palavras | 14 páginas
  • psicogama
    5754 palavras | 24 páginas