pain management Flashcards
Allodynia
pain associated with non noxious stimulus
Anaesthesia
absence of sensation
analgesia
absence of pain in presence of a noxious stimulus
distress
external display of suffering
hyperaesthesia
Increased sensitivity to a stimuli - alodynia and hyperalgesia
hyperalgesia
increased sensitivity to a noxious stimuli
hypoalgesia
decreased sensitivity to a noxious simuli
nociception
transduction, conduction and cns processing of a signal generated by the nociceptors
noxious stimuli
painful stimulus
pain
unpleasant sensory or physical experience associated with real or potential tissue damage
pain theshold
least level of pain that an individual can recognise
if under the threshold - nociceptor not activated
pain tolerance level
greatest level of pain that an individual can tolerate
suffering
unpleasant emotional state usually internalised not expressed outwardly
windup
Sensitisation of the nociceptors and pain pathways that occurs following prolonged severe nociceptive stimuli
- this results in expanced receptive fields to nociception
- increased rate of discharge of the nociceptors
- more pain
pain results in
1) behavioural changes
2.) autonomic nervous system stimulation (SNS)
3) neuroendocrine activation
- ACTH => Cortisol
- Catecholamines - Noradrenalin/ adrenalin
- renin - Aldosterone - ADH
- TSH => T4
- Growth hormones
- glucagon/ insulin
+ cytokine release IL1, IL 6 TNF -a
Consequences of pain
- ↑ HR - SNS
- ↑ coagulability
- ↑ metabolism
- ↓ immunity
multimodal analgesia
- use of 2 or more analgesis classes together
- work synergistically
- improved analgesgia with lower doses - ↓ Side / adverse effects
- ↓ likelyhood of chronic/wind up pain
- ↓ NE response
- ↓ healing time
- ↓ stress response - ↓ tissue catabolism and maintenance of the immune system
- ↓ pat
- ient interference
Acute pain
pain that begins abruptly and is brief in duration -
-eg superficial laceration - pain resolve when wound is healed
Cental pain
pain associated with a lesion in the CNS
eg. pain associated with MS
chronic pain
pain persisting beyond the time frame for healing or pain associated with a chronic pathological process
eg. OA or neoplastic pain
inflammatory pain
pain associated with tissue damage and inflammation
eg abscess
neuropathic pain
pain associated with peripheral NS or CNS
eg phantom limb pain
neuropathic pain
pain associated with peripheral NS or CNS
eg phantom limb pain
pathological pain
pain that is an exaggerated response for a longer period of time than the normal defence mechanism warrents and is associated with tissue injury
eg, peripheral or central sensitisation
