Anaesthetics- Essential Pain Management Flashcards
What is Pain?
Unpleasant sensory and emotional experience
What are the main characteristics of Pain?
It is a personal experience
It is influenced by biological, physiological and social factors
It is learnt through life experiences
What are the physical benefits of treating pain?
Improved sleep
Fewer medical complications
What are the psychological benefits of treating pain
Reduce anxiety and depression
What are the societal benefits of treating pain?
Able to contribute to the community
What are the different types of pain?
Acute Chronic Cancer Nociceptive Neuropathic
What is acute pain?
Pain of recent onset and limited duration
What is chronic pain?
Pain lasting more than 3 months
Outlasts normal healing
No identifiable cause
What is cancer pain?
- Progressive
* Mixture of acute and chronic
What is nociceptive pain?
- Obvious tissue injury or illness
- Physiological or inflammatory pain
- Protective function
- Well localised
How is nociceptive pain described?
Sharp and dull
What is neuropathic pain?
- Nervous system damage or dysfunction
- Abnormal processing of pain signal
- Tissue injury may not be obvious
- Does not have a protective function
- Not well localized
How is neuropathic pain described?
Burning, shooting and numbness, pins and needles
What are examples of neuropathic damage?
Nerve trauma
Diabetic pain
What is an example of neuropathic dysfunction?
Fibromyalgia
Chronic tension headache
What is the pathological mechanism of neuropathic pain?
- Increased receptor numbers
- Abnormal sensitisation of nerves: Peripheral or central
- Chemical changes in dorsal horn
What are the 4 parts of the physiology of pain?
Periphery
Spinal cord
Brain
Modulation
What occurs in the periphery?
- Tissue injury
- Release of chemicals
- Stimulation of pain receptors
- Signal travels in Aδ or C nerve to spinal cord
Which chemicals are released in the periphery?
Prostaglandins
Substance P
What is the name of the pain receptors that are stimulated?
Nociceptors
What occurs in the spinal cord?
- Dorsal horn is the first relay station
- Aδ or C nerve synapses with second nerve
- Second nerve travels up opposite side of spinal cord
What occurs in the brain?
- Thalamus is the second relay station
- Connections to many parts of the brain- Cortex, Limbic system, Brainstem
- Pain perception occurs in the cortex
What happens during modulation?
- Descending pathway from brain to dorsal horn
* Usually decreases pain signal
What is the management for pain in the periphery?
- Non-drug treatments: Rest, ice, elevation
- Non-steroidal Anti-inflammatory drugs
- Local anaesthetics
What is the non-pharmacological management for pain in the spinal cord?
Acupuncture
Massage
TENS
What are pharmacological managements for pain in the SC?
Local anaesthetics
Opioids
Ketamine
What is the non-pharmacological management for pain in the brain?
Psychological
What is the pharmacological management for pain in the brain?
- Paracetamol
- Opioids
- Amitriptyline
- Clonidine
What is the function of nociceptive pain?
