L12: Pain & pain states Flashcards
What is hyperalgesia?
Pain that is now more painful
eg. feeling around the finger after a papercut should not be painful but it is
What is allodynia?
Non-painful experiences that are now painful
eg. running a paintbrush over your skin shouldn’t hurt but now it does
How to manage acute pain?
WHO ladder but backwards, depending on severity
Non-pharmacological options eg. RICE (rest, ice, compression, elevation)
What is patient-controlled analgesia?
Standard prescription, given when patient requires
Dose block of 5 minutes –> gives time for drug to start having effect
Patient autonomy –> patients more in control of pain relief –> better outcomes
Commonly administered drugs: morphine, fentanyl, oxycodone
What is ketamine?
NMDA receptor antagonist
Used for anaesthesia/sedation, analgesic in subtherapeutic doses
Mainly used when opioids are ineffective or to reduce concurrent opioid doses
Hallucinogenic –> illicit use high
What is lignocaine (IV)?
Anti-inflammatory, analgesic
Relieve mechanical allodynia & hyperalgesia
What is regional anaesthesia?
Peripheral nerve blocks placed –> no signals fired
Nearby muscle fibres also blocked –> muscle weakness is common side effect
Steroids may be used concurrently to prolong block
May cause nerve injury, injury to other sites, motor block
What is epidural anaesthesia?
Used to facilitate deliveries
What are FOUR advantages of epidural analgesia?
Avoids systemic effects of opioids after bowel surgery eg. constipation
Reduce myocardial oxygen demand
Respiratory benefits eg. COPD
Less thromboembolic events
What are FIVE disadvantages of epidural analgesia?
CV effects esp. in IHD/anastomoses –> causes hypotension
Requires expertise
Can cause neurological injury
Anticoagulation required
Max. use 72 hours, so need to transition to something else
