post-operative pain Flashcards
Pain definition
Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage.
- Highly subjective
factor influences of pain
- memory of previous pain
- psychological factors of anticipated pain
- neural stimuli received from damaged tissue.
Acute pain definition
Lasts for a short time and occurs following surgery or trauma or other condition.
Chronic pain definition
Beyond the time expected for healing following surgery, trauma or other condition.
Cancer pain definiton
Occur in pt with early state and advanced disease, and in cancer survivors as a severe and debilitating side-effect of treatment.
Post-operative pain definition
Defined as ‘acute pain experienced immediately after surgery, up to 7 days’.
- Amount of pain is related to the extent of tissue damage and the site of surgery.
Physiological consequences of pain
Unrelieved pain is harmful to pt as it is a trigger of the stress response.
- Activates the autonomic nervous system and can cause adverse effects on various organ systems.
Physiological Neurological consequences of pain
- Confusion
- Distress
- Anxiety
- Impaired ability to think
Physiological cardiovascular consequences of pain
- Hypertension
- Unstable angina
- MI
- DVT
Physiological Resp consequences of pain
- Atelectasis (collapse of a part/ all of the lung)
- Hypoxia
- Hyper/hypoventilation
Physiological Endocrine/ metabolic consequences of pain
- Increased RR
- Increased HR
- Shock
- Hyperglycaemia
- Fluid overload
Hypertension
Physiological Immunological consequences of pain
- Decreased immune response
Physiological GI consequences of pain
- Nausea
- Paralytic ileus
- Vomiting
Physiological Renal/urological
consequences of pain
- Fluid imbalance
- Electrolyte disturbance
- Urinary retention
Physiological Musculoskeletal
consequences of pain
- Immobility
- Weakness
- Muscle spasms
Nociceptive pain definition
Pain arising from tissue damage
- Typically changes with movement position and load.
- Classified into somatic and visceral pain
Superficial somatic
- skin and superficial tissue
- Sharp, well defined, clearly located
- e.g., Superficial burn
Deep somatic
- Ligaments, bones, muscle, fascia
- Dull, aching, poorly localised
- e.g., Sprain, fractures
Visceral
- Organs, body cavities, blood vessels
- Generalised aching, dull, vague, hard to pinpoint
- Menstrual pain, bladder infection
Referred pain
Occurs as visceral sensory neurons share the same pathways with somatic reflex arcs.
- Causes the visceral pain to travel along the same pathway as somatic pain, so pain is perceived as somatic in origin.
- Occurs in response to deep somatic pain not superficial
E.g., MI - located in the mid/left side of the chest (visceral in origin), but it triggers pain in the jaw or left (deep somatic)
Neuropathic pain
Pain arising from nervous system damage (central or peripheral).
- From disease, injury or pinching.
- E.g., hitting your funny bone
- Anything that damages neurons
Other pain
Pain arising from neurological dysfunction, not damage.
- Used to describe pain that doesn’t fit within the nociceptive or neuropathic pathways.
Nocipathic pain
Pain doesn’t follow the normal nociceptive pain pathway, but is still responsive to nociceptive pain management.
Nociplastic pain
Problem arises from changes in how nociceptive pain works
Algopathic pain
Pathological perception/sensation
- E.g., phantom limb pain
Pain management aim
minimise the pt discomfort, facilitate early mobilisation and functional recovery, and prevent acute pain developing into chronic pain.
mild pain management
non-opioid +/- adjuvant therapy
mild-moderate pain management
‘weak’ opioid +/- non-opioid
+/- adjuvant therapy
moderate to severe pain management
‘strong’ opioid +/- non-opioid +/- adjuvant therapy
