Post-op pain mgmt Flashcards
painful response to a typical nonpainful stimulus
allodynia
Most significant RF of opioid abuse?
personal hx of substance abuse
family hx of substance abuse
young age
preadolescent sex abuse
mental disease
the drug
What is the scale you can use with kids to guess what their pain is?
Wong baker FACES scale
What can you do to tx a kid with pain initially?
distraction, tylenol, opioid okay, start low
What are four elements of pain?
transduction
transmission
modulation
perception
How do you block transduction of pain?
NSAIDs
Antihistamines
Membrane stabilizing agents
local anesthetic creams
opioids
How would you interfere with transmission of pain?
regional anesthesia -
- spinal
- epidural
- interscalene
- supraclavicular
- axillary
- femoral
- adductor canal
- popliteal
- ankle block
How can you interfere with modulation of pain in order to decrease pain?
inhibitory NT - GABA and glycine
Descending efferent input - NE, 5-HT, endorphins
How can you change perception of pain?
general anesthesia
- sevoflurane
- desflurane
- isoflurane
any antinociceptive regimen delivered at any time during the perioperative period that will attenuate pain induced sensitization
preventive analgesia
any analgesic regimen that is administered prior to surfical incision and is more effective at pain relief than the same regimen administered after surgery
preemptive analgesia
repetitive stimulation of WDR neurons by C-fibers
wind up
Where could you put a regional anesthetic for a thoracotomy?
paravertebral block
Where would you put a regional anesthetic for an open laparotomy or a C-section?
transversus abdominis plane block
