Pain Management Flashcards
(41 cards)
What are two types of pain?
- Nociceptive
- Neuropathic
What is nociceptive pain?
- Noxious stimulus (chemical, thermal, mechanical) of nociceptors releases neural chemicals that also stimulate other nociceptors
- Transmits signal to spinal cord
Sharp localized pain =
Large diameter, sparsely myelinated
Dull, aching pain =
Small diameter, unmyelinated
Perception of pain =
Conscious experience of pain
Pain impulse is relayed through ___
Thalamus
___ transmit pain
Higher cortical structures
Modulation =
- Inhibition of impulses via the brain stem (body’s natural response to pain so you can go and get help)
- Release of endogenous opioids, serotonin, NE, GABA
What is neuropathic pain?
- Sustained by abnormal processing of sensory input
- Nerve damage, persistent stimulation, autonomic dysfunction
- Burning, tingling, shocks, hyperalgesia, allodynia
Chronic pain
> 3 months OR past the time of normal tissue healing
PQRST for monitoring pain
P: palliative and provocative factors Q: quality R: radiation S: severity T: temporal relations
Addiction
Using the medication beyond what it’s intended for; negatively impacting their daily lives
Abuse
Use of the medication beyond its intended use
Tolerance
Not getting the same therapeutic effects at current dose
Dependence
Require the medication for regular activities of daily living/normal quality of life
Who is at risk for inadequate pain control?
- Racial and ethnic minority groups
- Women
- Elderly
- Persons with cognitive impairment
- Cancer and at the end of life
What is the optimal length of opioid prescriptions for general surgery procedures?
4 to 9 days
What is the optimal length of opioid prescriptions for women’s health procedures?
4 to 13 days
What is the optimal length of opioid prescriptions for musculoskeletal procedures?
6 to 15 days
What pain meds work on transduction?
- NSAIDs
- COX-2 inhibitors
- Antihistamines
- Topical local anesthetics
What pain meds work on conduction?
- Peripheral nerve block
- Local anesthetics
What pain meds work on transmission?
- Epidural block
- Local anesthetics
What pain meds work on modulation?
- Opioids
- Clonidine
- COX-2 inhibitors
What pain meds work on perception?
- Opioids
- Acetaminophen
- Clonidine
- TCAs
- Gabapentin
