Background. Chronic neuropathic pain is a condition affecting an increasing proportion of the general population and its management requires a comprehensive, multidisciplinary program. A growing body of evidence supports the use of hyperbaric oxygen therapy (HBOT) in several chronic neuropathic pain conditions; however, its role and efficacy remain unclear. Purpose. To summarize current evidence for the mechanistic rationale of HBOT in chronic neuropathic pain conditions and to evaluate its clinical efficacy. Methods. This narrative review was conducted after searching the following databases (Medline, Embase, Cochrane, PsycINFO, the Web of Science, Scopus, ClinicalTrials. gov, WHO ICTRP, and ProQuest Digital Dissertation) from January 1946 to March 2020. Articles published in English that involved either animal or human studies with acute or chronic neuropathic pain evaluating any HBOT-related intervention were included. Results. A total of 2971 citations were identified. A total of 29 studies were included in this review. The mechanisms of action for HBOT use in neuropathic conditions included the primary effects of hyperoxia and edema resolution, as well as the secondary effects pertinent to the production of oxygen and nitrogen reactive species (serving as pain signaling molecules), nitric oxide-dependent release of opioid peptides, and reduction of inflammatory mediators. A robust evidence for HBOT use in the clinical setting was associated with chronic regional pain syndrome and chronic primary bladder pain syndrome. Some evidence supported its use for chronic secondary (peripheral) neuropathic pain including radiation-induced plexus neuropathies, postherpetic neuralgia, and trigeminal neuralgia. Conclusions. HBOT has been shown to have antinociceptive and analgesic effects in animal models of inflammatory, neuropathic, and chronic pain. Human studies demonstrated beneficial effects of HBOT in improving clinical outcomes such as pain scores, pain-related symptoms, and quality of life. A systematic methodology of HBOT application is necessary to confirm its safety and efficacy.

中文翻译：

---

慢性神经性疼痛中高压氧疗法的机械原理和临床疗效：基于证据的叙述性评论

背景。慢性神经性疼痛是一种影响越来越多的普通人群的疾病，其管理需要综合的，多学科的计划。越来越多的证据支持在几种慢性神经性疼痛病症中使用高压氧疗法（HBOT）。但是，其作用和功效尚不清楚。目的。总结目前在慢性神经性疼痛情况下HBOT机制基本原理的证据，并评估其临床疗效。方法。该叙述性评论是在1946年1月至2020年3月搜索以下数据库（Medline，Embase，Cochrane，PsycINFO，Web of Science，Scopus，ClinicalTrials.gov，WHO ICTRP和ProQuest Digital Dissertation）之后进行的。涉及动物或人类研究的急性或慢性神经性疼痛，评估与HBOT相关的任何干预措施。结果。总共确定了2971次引用。该评价共纳入29项研究。在神经性疾病中使用HBOT的作用机制包括高氧和水肿消退的主要作用，以及与产生氧和氮反应性物质（用作疼痛信号分子）有关的次要作用，依赖一氧化氮的释放阿片肽，减少炎症介质。在临床环境中使用HBOT的有力证据与慢性区域性疼痛综合征和慢性原发性膀胱疼痛综合征相关。一些证据支持其用于慢性继发性（周围性）神经性疼痛，包括放射诱发的丛神经病，带状疱疹后神经痛和三叉神经痛。结论。HBOT在炎症性，神经性和慢性疼痛的动物模型中已显示出抗伤害性和镇痛作用。人体研究表明，HBOT在改善临床结果（例如疼痛评分，疼痛相关症状和生活质量）方面具有有益作用。必须使用系统的方法来确定HBOT的安全性和有效性。