Clinical Insights into Pain Sensitivity: A Narrative Review of Hyposensitivity

• DOI: https://doi.org/10.22533/at.ed.1594472429053

• Palavras-chave: Anesthesiology; Pain; Quality of life; Pharmacology

• Keywords: Anesthesiology; Pain; Quality of life; Pharmacology

• Abstract: INTRODUCTION Pain is a crucial biological signal that indicates potential harm, involving complex sensory processes that interpret severity and nature of pain through specific brain regions. Chronic pain affects about 20% of the global population, imposing significant economic and healthcare costs. Pain types vary from acute, which directly signals tissue damage, to chronic and neuropathic pains, each requiring distinct management strategies. Effective pain management is essential across all medical fields and extends to disciplines like psychology and ergonomics, emphasizing its universal impact on health and productivity. OBJETIVE To analyze and describe the main aspects of the different forms of hypoanesthesia and loss of sensitivity in recent years. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: "Congenital Insensitivity to Pain" AND "Hereditary Sensory and Autonomic Neuropathy" AND "Paroxysmal Extreme Pain Disorder" AND "Chemotherapyinduced Peripheral Neuropathy" AND "Pharmacological Modulation of Sensory Perception" in the last years. RESULTS AND DISCUSSION The study and management of pain, particularly in conditions involving hyposensitivity or an absence of pain sensation like Congenital Insensitivity to Pain (CIP) and Hereditary Sensory and Autonomic Neuropathy (HSAN), present profound clinical challenges. These disorders often lead to high risks of unnoticed injuries and infections due to the absence of pain feedback mechanisms. Management requires an in-depth understanding of the genetic factors involved, particularly mutations affecting the SCN9A gene linked to pain signal transduction, and tailored interventions aimed at preventing complications. Conditions like diabetic neuropathy and HIV-associated neuropathy further illustrate the complexity of pain management in cases of reduced pain sensitivity, demanding comprehensive strategies to address both the direct and secondary impacts of diminished pain perception. Additionally, the review underlines the importance of vigilant clinical practices and patient education to mitigate the risks associated with pharmacologically induced sensory alterations in pain perception. Effective pain management is crucial across all medical specialties and is necessary for improving patient outcomes in a broad spectrum of health conditions. CONCLUSION The narrative review thoroughly examines the challenges in managing congenital, acquired, and pharmacologically induced hyposensitivity to pain, underscoring the need for a deep genetic understanding, vigilant monitoring, and interdisciplinary care to prevent unnoticed injuries and complications. It also explores the complexities of acquired disorders like diabetic and HIV-associated neuropathy, requiring integrated approaches that combine rigorous disease management with proactive preventive measures against sensory impairments. Furthermore, the review delves into the risks associated with pharmacological agents used in pain management and anesthesia, advocating for precise dosing, strict monitoring, and comprehensive patient education to mitigate potential injuries and enhance patient safety.