Types Of Pain Flashcards
Duration of pain - acute
Abrupt or brief event, usually related to trauma, surgery or infection and medical disease
- pancreatitis, cystitis, cholecystitis
Duration of pain - chronic
maladaptive
Pain persist beyond a responsible time for the course of an acute disease or an injury to heal
Origin of pain - somatic
Originates from damage to somatic tissues (bones, joints, muscles, skin)
Sharp & localized pain
Origin of pain - visceral
Arises from visceral injury (generalized)
Not well localized, associated w nausea & vomit
Location of neuropathic pain
Direct damage to peripheral nerves or spinal cord
Burning or shooting pain, difficult to treat
Adaptive inflammation in spinal cord & brain
Spontaneous pain & hypersensitivity to pain in response to tissue damage & inflame. Occurs w tissue trauma or injury, surgery
- responds to treatment
Adaptive nociceptive response from spinal cord & brain
Transient pain in response to a noxious stimulus. Small aches & pains, protect body from enviro
- pinching finger
Maladaptive neuropathic response in SC or brain
Spontaneous Pain & hypersensitivity to pain in association w damage to or a lesion of the NS
Maladaptive functional response of SC or brain
Hypersensitivity to pain resulting form abnormal processing of normal input
Changes in CNS w chronic pain
Alteration of cell phenotype
Expression of novel proteins (receptors)
Changes in neurotransmitter & ion channels
Changes in neural structure (cell loss, synaptic reorganization)
Duration of chronic pain
Serves no useful biological or adaptive function
NS becomes the focus of pathology
Chronic pain and surgery
Pain persisting at least 3 months after surgery
Pain not present before surgery or that has different characteristics or increased intensity from pre operative pain
Pain is localized to the surgical site or referred area
Exclude other causes (Cancer, recurrence, infection)
Post surgical pain incidence
1-2/10 patients and is intolerable after 1/100 ops
Type and intensity of surgery increase pain
Types of pain w high pain
35% thoracotomy and breast surgery
20% knee arthroplasty
10% hip arthroplasty
High intensity surgeries
Joint arthroplasty > gynecological or visceral ops
Chronic inflammatory disease
Otitis, pancreatitis, interstitial cystitis
Chronic orthopedic disease
Osteoarthritis
Lumbosacral instability
Chronic soft tissue injury
Degloving injury
Radiation - induced pain
Nervous tissue injury
Post amp pain
Post thoracotomy pain
Intervertebral disk disease
Cancer & chronic pain
Chondrosarcoma
Osteosarcoma
Nerve sheath tumor
Perception of cerebral cortex pain
3rd order neuron
Analgesics for cerebral cortex perceived pain
Anesthetic
Opioids
Alpha 2 antagonists
Benzodiazepines
Phenothiazines
NSAIDS
Location of modulation
Dorsal horn of spinal cord
Analgesics for modulatory pain
Local anesthetic
Tricyclic antidepressants
Cholinesterase inhibitors
NMDA antagonists
Opioids
NSAIDS
Alpha 2 antagonists
Anticonvulsants
Location of transmission
First order neuron (primary afferent)
Analgesics for transmission of pain
Sensory nerves
Local anesthetic
Alpha 2 antagonists
Analgesics for transduction of pain through sensory nerve endings
Local anesthetic
Opioids
NSAIDS
Corticosteroids
Preemptive analgesia
Not only previous (preventive analgesia) to surgical stimulus but also during and after stimulus
Constant rate infusion
Keeping plasma levels of given drug more consistent
Eliminates the need for repeated administration
