Analjezik Sistemi Etkileyen Potansiyel Yollar

Yıl 2024, Cilt: 9 Sayı: 1, 157 - 183, 31.03.2024

Dursun Alper Yılmaz , Mehmet Emin Atay

https://doi.org/10.25279/sak.981456

Öz

Ağrının birincil önemi vücudu yaralanmalardan korumaktır. Ancak, hayatta kalmak için acıyı algılamamanın daha önemli olduğu bazı durumlar da söz konusudur. Ağrının kendiliğinden bastırılması veya nosisepsiyonun zayıflamasına, endojen antinosiseptif (analjezik) sistem aracılık eder. Anatomik oluşumu, orta beyindeki periakueduktal gri maddeden, beyin sapının noradrenerjik ve serotonerjik çekirdeklerinden, nosiseptörlerden "ağrı" bilgisi alan spinal nöronlara kadar uzanır. Bu sistemin faaliyeti, duygusal ve bilişsel devrelerin kontrolü altındadır. Ağrı, olumlu duyguların uyarılmasıyla hafifletilebilirken, olumsuz duygular hissedilen acıyı artırmaktadır. İlginç şekilde, bir ağrı başka bir acıyı bastırabilme özelliğine de sahiptir. Analjezi; stres, fiziksel egzersiz, orosensöryel uyarılma (tatlı gıda tüketimi), müzik dinleme ve plasebo sonrası, yani ağrıdan kurtulma beklendiğinde duyusal uyarımla indüklenebilir. Ağrının; duyusal, duyuşsal ve bilişsel bileşenleri olduğundan, bu tüm sistemlerin aktivasyonunun belirli şekillerde ağrının bastırılmasına katkıda bulunabileceği ortaya konmuştur.

Anahtar Kelimeler

Ağrı yönetimi, Analjezi, Stres

Potential Ways to Affect the Analgesic System

Öz

The primary importance of pain is to protect the body from injuries. However, there are some situations where not perceiving pain is more important for survival. Spontaneous suppression of pain or attenuation of nociception is mediated by the endogenous antinociceptive (analgesic) system. Its anatomical formation extends from the periaqueductal gray matter in the midbrain to the noradrenergic and serotonergic nuclei of the brain stem to spinal neurons that receive "pain" information from nociceptors. The activity of this system is under the control of emotional and cognitive circuits. Pain can be alleviated by stimulation of positive emotions, while negative emotions increase the pain felt. Interestingly, one pain also has the ability to suppress another pain. Analgesia; can be induced by stress, physical exercise, orosensory arousal (consumption of sweet food), listening to music, and sensory stimulation after placebo, i.e. when pain relief is expected. Since pain has sensory, affective, and cognitive components, it has been demonstrated that the activation of all these systems may contribute to the suppression of pain in certain ways.

Anahtar Kelimeler

Stress, Analgesia, Pain Management

Kaynakça

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