Acute Pain

Question 1

What is pain?

Answer 1

Physiologic response to noxious chemical, thermal, or mechanical stimulus; associated with invasive procedures, trauma, and disease; generally time-limited until injury heals.

Question 2

What are the clinical features of pain?

Answer 2

Severity, onset (acute or chronic), location, duration, character, physiologic associated features incl HR, RR, BP, sweating

Question 3

What is the differential diagnosis for acute pain?

Answer 3

Acute, Chronic (nociceptive vs neuropathic), acute on chronic pain, anxiety/panic, malingering

Question 4

If pain in the perioperative setting appears out of proportion to surgery/procedure or is new in onset what should you do?

Answer 4

Pursue history, phys exam, appropriate labs, imaging, surgical consultation

Question 5

In addition to opioids, what treatments are available for a multimodal approach for the treatment of acute pain?

Answer 5

Generally speaking, nonopioid analgesics (tylenol, NSAIDs, alpha-2 agonists),
gabapentin, NMDA antagonists, local anesthetics, PNB, neuraxial analgesia