PDF(Pubmed)
Abstract：
Incoercible or intractable pain is defined as pain that is refractory to pharmacological treatment to such an extent that opioid and analgesic adverse effects outweigh the therapeutic effects. The anterior cingulate cortex (ACC) is involved in the perception of pain, especially emotional pain, so it is logical that cingulotomy has an effective therapeutic effect. Therefore, we evaluated the effectiveness of cingulotomy for the treatment of incoercible pain. An observational, longitudinal, retrospective, and analytical study was carried out on a series of cases in which bilateral cingulotomy was performed for incoercible pain, and follow-up was performed 6 months after neurosurgery in the outpatient clinic at the Neurotraumatology Clinic. A positive correlation was observed between pain intensity and medication use, indicating that an increase in pain was associated with a greater requirement for analgesics. The result was a significant reduction in pain, as measured by the visual analog scale of pain, and decreased drug use after cingulotomy. We concluded that cingulotomy reduces incoercible pain and the need for medication.
摘要：
不可胁迫性或顽固性疼痛被定义为药物治疗难以治疗的疼痛,其程度使得阿片样物质和镇痛副作用超过治疗效果。前扣带皮质（ACC）参与疼痛的感知，尤其是情感上的痛苦，因此，扣带切开术具有有效的治疗效果是合乎逻辑的。因此,我们评估了扣带切开术治疗不可迫性疼痛的有效性。一个观察,纵向,回顾性,并对一系列病例进行了分析研究，在这些病例中，进行了双侧扣带切开术以治疗不可预见性疼痛，随访6个月后在神经创伤门诊门诊进行.观察到疼痛强度与药物使用之间呈正相关，这表明疼痛的增加与对镇痛药的需求增加有关。结果是疼痛明显减轻，根据疼痛的视觉模拟量表，扣带切开术后药物使用减少。我们得出的结论是，扣带切开术减少了不可强迫性疼痛和药物治疗的需要。
