Pain management

Question 1

what is the acceptable pain continuum

Answer 1

Question 2

how do you assess pain in practice?

Answer 2

Biological / neurophysiological aspects: Pain intensity
Pain score/scale
Visual analogue scale, numeric verbal scale, simple verbal scale, behavioural pain scale, paediatric scales

Functional interference
Acute Pain: DrEAMS
Drinking, eating, absence of severe pain, mobilising including breathing and coughing, sleeping
Acute and Chronic pain
Self-efficacy, quality of recovery, quality of life, return to work

Psychological distress:
How are you doing? Are you comfortable?

Question 3

step one pain management

Answer 3

Question 4

step two pain management

Answer 4

Question 5

step three pain management

Answer 5

Question 6

pain receptor pathway

Answer 6

Question 7

Multimodal analgesia

Answer 7

Locoregional analgesia (central, peripheral blocks)

Ketamine (low ‘anti-hyperalgesic’ doses)

Magnesium sulfate

Alpha-2 agonists: clonidine and dexmedetomidine

Paracetamol

Non-steroidal anti-inflammatory drugs

Question 8

pain management

Answer 8

Question 9

Codeine, tramadol and CYP2D6

Answer 9

Question 10

CYP2C9
CYP2D6
CYP3A4

Answer 10