Essential pain management Flashcards
What is pain?
An unpleasant sensory and emotional experience associated with or resembling that associated with actual or potential tissue damage, or described in terms of such damage
What is nociception?
Neural processes of encoding and processing noxious stimuli
What are some physical benefits of treating pain?
Improved sleep
Better appetite
Fewer medical complications like heart attack or pneumonia
What are some psychological benefits of treating pain?
Reduce suffering
Less depression and anxiety
What are the 2 mechanism classifications of pain?
Nociceptive
Neuropathic
What are the 2 cause classifications of pain?
Cancer
Non-cancer
What are the 3 duration classifications of pain?
Acute
Chronic
Acute on chronic
What is the usual description of nociceptive pain?
Sharp and/or dull
Well localised
What is the usual description of neuropathic pain?
Burning Shooting Numbness Pin and needles Not well localised
What are the 4 physiological steps in pain?
Periphery
Spinal cord
Brain
Modulation
Which nerves might signals travel through from nociceptors to spinal cord?
Aδ
C
Which part of the spinal cord is the first relay station for nociception?
Dorsal horn
What is the second relay station for nociception/peripheral stimuli?
Thalamus
Where does pain perception occur?
Cortex
What is pain modulation?
Descending pathway from brain to dorsal horn
Usually decreases pain signal
What are some causes of neuropathic pain?
Increased receptor numbers
Abnormal sensitisation of nerves
Chemical changes in the dorsal horn
Loss of normal inhibitory modulation
What kinds of drugs are used for spinal cord pain?
LAs
Opioids
Ketamine
What are some non-drug treatments for spinal cord pain?
Acupuncture
Massage
TENS
What kind of drugs are used to treat brain pain?
Paracetamol
Opioids
Amitriptyline
Clonidine
Are NSAIDs good for nociceptive pain?
Yes
Is codeine good for neuropathic pain?
No
What kind of pain would codeine be good for?
Mild-moderate acute nociceptive pain
Name a good drug for moderate-severe nociceptive pain?
Morphine
What does amitriptyline do?
Tricyclic antidepressant (TCA) Increases descending inhibitory signals
Which pain scale is used for confused patients?
Abbey Pain Scale
What does RAT stand for?
Recognise
Assess
Treat
What is an appropriate treatment for mild nociceptive pain?
Paracetamol
What are some drugs to consider for neuropathic pain?
Amitriptyline
Gabapentin
Duloxetine
