Non Pharmacological Treatments Of Pain Flashcards
Effects of untreated pain - increased
SNS^ activity
^HR, BP, SVR, VO2
Change in regional blood flow = changes in healing
Effects of untreated pain - decreased
V motility - venous stasis, muscle wasting
Deep vein thrombosis
Muscle atrophy, neuropathies
Couch, v lung expansion, change in PO2 = ^ risk of infection
Effects of untreated pain - GIT
V GIT motility & constipation = more pain
Catabolic breakdown of metabolism, hyperglycemia, protein breakdown
- hyper coagulability
- immune suppression = v wound healing, v resist to infection
- adrenal exhaustion = v serum levels of GC
Reasons for inadequate use of analgesia
Failure to recognize pain
Lack of validated assessment
Lack of regular or frequent pain assessments
Phantom limb pain
Pain perceived by region of body no longer present
Mechanisms in phantom limb pain
Peripheral
Central
Psychogenic
Peripheral mechanisms
Peripheral - stump or neuroma hyperactivity
Central mechanisms
Central - spinal cord sensitization, cortical reorganization
Psychogenic predisposing factors
- size of amputation
- degree of pain
- presence of pre-amputation pain
Treatment for phantom limb pain
Bupivacaine & morphine
Epidural provided better immediate post op relief
Non-pharm pain management
Gentle handling
Nursing care, clean & sanitary
Weight optimization
Environmental modifications
PRICE
Protection
Rest
Ice
Compression
Elevation
Rest
Rest & bracing 48-72 hours
Ice
Most important in acute injury management of pain
Decrease metabolism
Vasoconstriction
Nerve conduction
>10 min
Use of heat compresses
Chronic pain, decrease pain & increase BF to increase metabolism
