Acute pain syndromes in injuries to the nerves and plexuses of the limbs

Abstract

Injuries of peripheral nerves and plexuses cause serious disorders in the affected limbs. Unfortunately, the fre-quency of nerve injuries and limb plexuses is steadily increasingin our country, due to hostilities, which empha-sizes the extreme relevance of this pathology.The aim of the review is to consider the current data on pathophysiological mechanisms, clinical manifestations, and treatment of acute pain syndromes in patients with injuries of peripheral nerves and limb plexuses.Materials and methods.Scientific databases PubMed, Google Scholar, Scopus, Cochrane Library, as well as the materials of the International Association for the study of pain were used to searchfor sources of research information. The main studies were found in Pubmed, Google Scholar and materials of the International Associ-ation for the study of pain and made up 191 sources of information, 150 of which were excluded from the review due to insufficient data on pathophysiological mechanisms, clinical manifestations, and treatment of pain syn-dromes in patients with damage to the nerves and plexuses of the limbs, thus 41 sources of information formed the basis of the review.Results:Brachial plexusand peripheral nerve injuries can be associated with any combination of nocicep-tive, neuropathic, phantom limb pain, and even complex regional pain syndromes. Acute neuropathic pain is an under-recognized condition, often difficult to treat and can progress to persistent pain and disability. Neuropathic pain develops because the main damage affects the somatosensory system. It is caused by pe-ripheral nerve damage and associated changes in the central nervous system. The first line of pharmaco-logical treatment for neuropathic pain according to current guidelines is anticonvulsant drugs that affect neuronal calcium channels, as well as tri-and tetracyclic antidepressants and selective seroto-nin/norepinephrine reuptake inhibitors.Conclusions: At the current stage, progress has been made in understanding the mechanisms of development of the pathological condition and in the development of therapeutic approaches, however, the chronicity of pain syndrome in patients with damage to the nerves and plexuses of the limbs is still high, which requires further re-search to develop complex pathogenetic therapy and better understanding of the mechanisms pain in this cate-gory of patients.