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

Frontiers in Systems Neuroscience

Neuroscience

Nicolas Lejeune¹  Aurore Thibaut²  Emilie Szymkowicz²  Olivia Gosseries²  Estelle A. C. Bonin²  Charlotte Martial²  Steven Laureys³  Vincent Bonhomme⁴ 

[1] Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium;Centre Hospitalier Neurologique (CHN) William Lennox, Saint-Luc Hospital Group, Ottignies-Louvain-la-Neuve, Belgium;Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium;Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium;Centre du Cerveau, Liège University Hospital, Liège, Belgium;Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium;Centre du Cerveau, Liège University Hospital, Liège, Belgium;Joint International Research Unit on Consciousness, CERVO Brain Research Centre, Centre Intégré Universitaire de Santé et Services Sociaux (CIUSS), University Laval, Québec City, QC, Canada;Department of Anesthesia and Intensive Care Medicine, Liège University Hospital, Liège, Belgium;Anesthesia and Perioperative Neuroscience Laboratory, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium;

关键词: pain;    nociception;    disorders of consciousness;    locked-in syndrome;    pain assessment;    pain management;    theories of pain;   

DOI  :  10.3389/fnsys.2023.1112206

 received in 2022-11-30, accepted in 2023-03-06,  发布年份 2023

来源: Frontiers

【 摘 要 】

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.

【 授权许可】

Unknown   
Copyright © 2023 Bonin, Lejeune, Szymkowicz, Bonhomme, Martial, Gosseries, Laureys and Thibaut.