analgesia (pain assessment)

Question 1

Somatic pain

Answer 1

Referred to as musculo-skeletal pain
Sharp, localised and can be reproduced by
touching or moving the area involved
Somatic pain comes from:
• Skin
• Muscle
• Joints
• Bones and ligaments

Question 2

Visceral pain

Answer 2

• Originates in internal organs
• Activated by pain receptors for inflammation and ischaemia
• Poorly localised
• Presents as a dull ache or cramping.
• Often produces referred pain into the back.

Question 3

mechanism of pain (4)

Answer 3

1. Stimulation of pain receptors
2. Generation of pain signals
3. Processing of pain signal
4. Physiologic response to pain

Question 4

difference between sign and symptom

Answer 4

Sign: something you can see, hear etc)

Symptom: what the patient tells you

Question 5

PQRST

Answer 5

P = Promotion or exacerbating factors
• Q = Quality
• R = Radiation and location
• S = Severity or Score
• T = Time

Question 6

pain Intervention

Non pharmacological

Answer 6

• Heat/cold packs
• Massage
• Exercise
• Rest, elevation
• Positioning
• Relaxation breathing

Question 7

pain Intervention

pharmacological

Answer 7

• Opioid/Opiates
• Non opioid
• Patient Controlled Analgesia
• Epidurals
• Nerve blocks

Question 8

Adverse Effects of Narcotics

Answer 8

CNS: sedation, euphoria, dysphoria
Resp: respiratory depression
CVS: hypotension
Renal: urine retention
GIT: nausea, vomiting,
constipation
Eyes: pinpoint pupils sign of overdose
Addiction with prolonged use!!

Question 9

Respiratory Depression

Answer 9

• Most serious effect of opioids
• Best judged by the degree of sedation -reduction of
respiratory rate may be a late indicator of overdose
• Sedation can be monitored by using a sedation
score
– 0 – wide awake
– 1 – easy to rouse
– 2 – easy to rouse, but cannot stay awake
– 3 – difficult to rouse
Aim: to keep sedation score < 2

Question 10

Opium

Answer 10

is extracted from the opium poppy and contains
many different compounds including:
Morphine
Codeine
Papaverine

Question 11

difference between opiates and opioids

Answer 11

Opiates
• Natural derivative of opium
• Includes- morphine, codeine, heroin
Opioids
• Synthetic
• “opium-like” action - pethidine

Question 12

types of drugs used for pain relief

Answer 12

morphine 
burpernophine
codeine
pethidine
dextropropoxyphene
oxycodone
targin
fentanyl
tamadol
methadone

Question 13

NSAID’s

Non-Steroidal Anti-Inflammatory Drugs.

Answer 13

These include:
• Aspirin
• Ibuprofen
• Diclofenac
• Celecoxib
NSAIDs block a specific enzyme called
cyclooxygenase (or COX) used by the body to make
prostaglandins. By reducing production of
prostaglandins, NSAIDs help relieve the discomfort
of fever and reduce inflammation and the associated
pain.