Actualización en el manejo del dolor: ¿Qué nuevas herramientas tenemos disponibles?
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Resumo
El abordaje contemporáneo del dolor crónico ha evolucionado desde modelos sintomáticos hacia una visión integradora basada en la neurobiología, la medicina traslacional y la personalización terapéutica. Esta revisión explora los avances más recientes en el tratamiento del dolor, incluyendo estrategias farmacológicas dirigidas, neuromodulación no invasiva, plataformas digitales, terapias cognitivas, y biomarcadores genéticos y neurofisiológicos. Se destacan intervenciones emergentes como los bloqueadores selectivos de canales de sodio (e.g., VX-548), terapias digitales como la realidad virtual inmersiva y programas autoguiados, así como el uso de neuromodulación cortical y medular combinada con análisis computacional. Además, se abordan enfoques que reconceptualizan el dolor como una experiencia cerebral moldeada por factores afectivos, cognitivos y contextuales, como la Pain Reprocessing Therapy y el placebo con activación neurofisiológica. La integración entre disciplinas como anestesiología, neurología, psiquiatría, genética y bioingeniería ha posibilitado la transición hacia una medicina del dolor de precisión, proactiva y centrada en el paciente. Esta revisión destaca el valor de la investigación traslacional y el desarrollo de herramientas personalizadas para mejorar la eficacia analgésica, reducir la carga funcional y optimizar la calidad de vida de las personas con dolor crónico.
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