Anaesthetics- Essential Pain Management

Question 1

What is Pain?

Answer 1

Unpleasant sensory and emotional experience

Question 2

What are the main characteristics of Pain?

Answer 2

It is a personal experience
It is influenced by biological, physiological and social factors
It is learnt through life experiences

Question 3

What are the physical benefits of treating pain?

Answer 3

Improved sleep

Fewer medical complications

Question 4

What are the psychological benefits of treating pain

Answer 4

Reduce anxiety and depression

Question 5

What are the societal benefits of treating pain?

Answer 5

Able to contribute to the community

Question 6

What are the different types of pain?

Answer 6

Acute 
Chronic 
Cancer
Nociceptive 
Neuropathic

Question 7

What is acute pain?

Answer 7

Pain of recent onset and limited duration

Question 8

What is chronic pain?

Answer 8

Pain lasting more than 3 months
Outlasts normal healing
No identifiable cause

Question 9

What is cancer pain?

Answer 9

• Progressive

* Mixture of acute and chronic

Question 10

What is nociceptive pain?

Answer 10

• Obvious tissue injury or illness
• Physiological or inflammatory pain
• Protective function
• Well localised

Question 11

How is nociceptive pain described?

Answer 11

Sharp and dull

Question 12

What is neuropathic pain?

Answer 12

• 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

Question 13

How is neuropathic pain described?

Answer 13

Burning, shooting and numbness, pins and needles

Question 14

What are examples of neuropathic damage?

Answer 14

Nerve trauma

Diabetic pain

Question 15

What is an example of neuropathic dysfunction?

Answer 15

Fibromyalgia

Chronic tension headache

Question 16

What is the pathological mechanism of neuropathic pain?

Answer 16

• Increased receptor numbers
• Abnormal sensitisation of nerves: Peripheral or central
• Chemical changes in dorsal horn

Question 17

What are the 4 parts of the physiology of pain?

Answer 17

Periphery
Spinal cord
Brain
Modulation

Question 18

What occurs in the periphery?

Answer 18

• Tissue injury
• Release of chemicals
• Stimulation of pain receptors
• Signal travels in Aδ or C nerve to spinal cord

Question 19

Which chemicals are released in the periphery?

Answer 19

Prostaglandins

Substance P

Question 20

What is the name of the pain receptors that are stimulated?

Answer 20

Nociceptors

Question 21

What occurs in the spinal cord?

Answer 21

• Dorsal horn is the first relay station
• Aδ or C nerve synapses with second nerve
• Second nerve travels up opposite side of spinal cord

Question 22

What occurs in the brain?

Answer 22

• Thalamus is the second relay station
• Connections to many parts of the brain- Cortex, Limbic system, Brainstem
• Pain perception occurs in the cortex

Question 23

What happens during modulation?

Answer 23

• Descending pathway from brain to dorsal horn

* Usually decreases pain signal

Question 24

What is the management for pain in the periphery?

Answer 24

• Non-drug treatments: Rest, ice, elevation
• Non-steroidal Anti-inflammatory drugs
• Local anaesthetics

Question 25

What is the non-pharmacological management for pain in the spinal cord?

Answer 25

Acupuncture
Massage
TENS

Question 26

What are pharmacological managements for pain in the SC?

Answer 26

Local anaesthetics
Opioids
Ketamine

Question 27

What is the non-pharmacological management for pain in the brain?

Answer 27

Psychological

Question 28

What is the pharmacological management for pain in the brain?

Answer 28

• Paracetamol
• Opioids
• Amitriptyline
• Clonidine

Question 29

What is the function of nociceptive pain?