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Anaesthetics > Pain > Flashcards

Pain Flashcards

1
Q

What is pain?

A

An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage

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2
Q

What are the physical benefits of treating pain?

A

Improved sleep, better appetite, fewer medical complications

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3
Q

What are the psychological benefits of treating pain?

A

Reduced suffering

Less depression, anxiety

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4
Q

What benefits can the family experience when pain is treated?

A

Improved functioning as a family member

Able to keep working

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5
Q

What benefits can society experience when pain is treated?

A

Lower health costs

Able to contribute to the community

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6
Q

How can the duration of pain be classified?

A

Acute
Chronic
Acute on Chronic

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7
Q

What is the cause of pain?

A

Cancer or non-cancer

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8
Q

How can the mechanism of pain be classified?

A

Nociceptive

Neuropathic

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9
Q

What is nociceptive pain?

A 
Obvious tissue injury or illness
Physiological pain or inflammatory pain
Protective dunction
Well localised
Sharp/dull
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10
Q

What is neuropathic pain?

A 
Nervous system damage or abnormality
Tissue injury may not be obvious
Does not have a protection function
Burning/shooting/numb/pins and needlese
Not well localised
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11
Q

How is pain perceived at the peripheries?

A

Tissue injury where release of chemicals stimulates nociceptors and signal travels along A Delta or C nerve fibres to spinal cord

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12
Q

What part does the spinal cord play in the pain pathway?

A

Dorsal horn is first relay station

ADelta or C nerve synapses with second nerve and then travels up contralateral side of spinal cord

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13
Q

What role does the brain play in the pain pathway?

A

Thalamus acts as second relay station and connects to cortex, limbic system, brainstem
Pain perception occurs in cortex

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14
Q

What pathways modulate pain?

A

Descending pathways

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15
Q

What are simple analgesics?

A

NSAIDs or Paracetamol

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16
Q

Give examples of opioids

A

Coedine, dihydrocoedine (Mild)

Morphine, oxycodone, fentanyl (strong)

17
Q

What is tramadol?

A

Mixed opiate andd 5HT/Na reuptake inhibitor

18
Q

What is Nefopam?

A

NMDA R antagonist, 5HT/Na reutake inhibitor

19
Q

Name some antidepressants?

A

Amitriptyline, duloexetine

20
Q

Name some anticonvulsants?

A

Gabapentin

21
Q

Name a NMDA receptor antagonist?

A

Ketamine

22
Q

Name a topical agent?

A

Capsaicin

23
Q

How does one treat a peripheral injury?

A

RICE
NSAID
local anaesthetics

24
Q

How does one treat a spinal cord injury?

A

Acupuncture, massage,TENS
Local anaesthetics
Opioids
Ketamine

25
Q

How does one treat a brain injury?

A

Paracetamol
Opioids
Amitryptyline
Clonidine

26
Q

What are the benefits of paracetamol?

A

Cheap, safe

Oral, rectal or IV administered

27
Q

What are the disadvantages of paracetamol?

A

Liver damage in overdose

28
Q

What are the advantages of NSAIDs?

A

Cheap and safe

Good for nociceptive pain

29
Q

What are disadvantages of NSAIDs?

A

GI and renal side effects

30
Q

What are the advantages and disadvantages on codeine?

A

Advantages
Cheap, safe
Good for mild-moderate acute nociceptive pain
Best given regularly with paracetamol

Disadvantages
Constipation
Not good for chronic pain

31
Q

What are the advantages and disadvantages of tramadol?

A

Advantages
Less respiratory depression
Can be used with opioids and simple analgesics
Not a controlled drug

Disadvantages
Nausea and vomiting

32
Q

What are the advantages of morphine?

A 
Cheap, generally safe
Can  be given orally, IV, IM, SC
Effective if given regularly
Good for:
Mod-severe acute nociceptive pain (e.g. post-op pain)
Chronic cancer pain
33
Q

What are the disadvantages of morphine?

A

Constipation
Respiratory depression in high dose
Misunderstandings about addiction
Controlled drug

34
Q

What is the oral dose of morphine?

A

2-3 times IV / IM / SC dose

35
Q

What are advantages of amitryptiline?

A

Cheap, safe in low dose
Good for neuropathic pain
Also treats depression, poor sleep

36
Q

What are the disadvantages of amitryptiline?

A

Anti-cholinergic side effects (glaucoma and urinary retention)

Anaesthetics (5 decks)

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