Principles of pain management

Question 1

Define pain.

Answer 1

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.

Question 2

How do you assess pain?

Answer 2

SOCRATES

Question 3

How is pain classified?

Answer 3

Duration

What is the mechanism?

Question 4

What is the difference between acute and chronic pain

Answer 4

Pain can be acute ( pain for less than 3 months) or chronic ( pain for more than 3 months)

Sometimes a patient in pain may experience additional acute pain ( acute on chronic pain)

Question 5

What is nociceptive pain?

Answer 5

Commonest type of pain following tissue injury

Sometimes called physiological or inflammatory pain

Has a protective function

Patients describe pain as sharp, throbbing or aching and is usually well localized.

Question 6

What is neuropathic pain?

Answer 6

Caused by a lesion or disease of the sensory nervous system and is sometimes called pathological pain.

Tissue injury may not be obvious and doesn’t have any protective function.

Patient describe neuropathic pain as burning or shooting.

They may complain of numbness or pins and needles

The pain is often not well localized

Question 7

How can severity of pain be measured?

Answer 7

i) Verbal rating scale
ii) Visual analogue scale
iii) Faces pain scale

Question 8

Give 2 non-pharmacological treatment options for pain.

Answer 8

i) RICE (rest, ice, compression and elevation) of injuries
ii) Splinting
iii) Acupuncture
iv) Physiotherapy

Question 9

Give 2 pharmacological treatment options for pain.

Answer 9

Systemic analgesia

Topical

Transdermal patch

Nerve blocks

Question 10

WHO Analgesic Ladder

Answer 10

REVISE

Question 11

What does good pain control involve?

Answer 11

Adequate pain assessment

Timely and appropriate analgesia administration

Frequent monitoring and reassessment

Additional analgesia where necessary