Nociplastic pain chronic primary pain; ex. cancer or fibromyalgia; not classified as nocicpetive or enuropathic transduction activation of pain receptors enkephalins inhibit release of substance P to reduce pain sensation prostaglandins send additional pain stimuli to CNS NSAIDs Contraindicated with bleeding disorders, probable infections and pregnancy >/+ 20 weeks EMLA cream cover w/ occlusive dressing 1hr prior to procedure for local pain relief modulation process by which the sensation of pain is inhibited or modified addiction chronic, relapsing brain disease; compulsive drug seeking Hypnosis produces a subconscious state accomplished by suggestions made by hypnotist acute pain rapid in onset; mild to severe; protective in nature Pain tolerance max intensity of stimulus that produces pain a person is willing to accept Pasero Opioid- Induced Sedation Scale used to assess respiratory depression S1234 Opioid analgesic Assess for respiratory depression with these meds; reversal Narcan (naloxone) 30 degrees HOB elevation for epidural analgesia bradykinin vasodilator; triggers release of histamine; assists in inflammation s/s FLACC pain scale for 2 months to 7 years serotonin stimulate smooth muscles, inhibit gastric secretion; cause vasoconstriction Acetaminophen viewed as one of the safest & best- tolerated analgesics pain it is what pt says it is substance P sensitizes receptors on nerves to feel pain; increase nerve firing rate PCA pump to be operated by patient only CRIES pain scale used for neonates (0-6mo.) nociceptors peripheral/pain receptors; respond to selective stimuli Multimodal analgesic therapy combines 2+ classes of analgesics that target different sites in peripheral and CNS to maximize pain relief pain threshold min. intensity of a stimulus that is perceived as painful Tolerance body becomes accustomed to opioid and need larger doses Postherpetic neuralgia follows acute CNS infection (ex. herpes zoster - shingles) Gate Control Theory pain is believed to be controlled by closing the gating mechanism in the spinal cord Nociceptive pain represented by normal pain process Visceral pain poorly localized; originates in thorax, cranium and abdomen; usually r/t disease Oral (po) Preferred route of medication for cancer pain Intractable pain resistant to therapy; no relief from interventions nocebo harmful or undesirable response from placebo Somatic pain diffuse; originate in tendons, ligaments, bones blood vessels or nerves referred pain pain originates in one part of body but perceived in area distant from point of origin Sharp quality of pain that is stabbing and intense Neuropathic pain caused by lesion or disease of peripheral or central somatosensory nervous system Diversion any act that results in a controlled drug not reaching the prescribed pt placebo sham med or procedure designed and known to not be of any therapeutic clinical value Cutaneous pain superficial; involves skin or SQ tissue; ex. paper cut transmission pain sensation from site of injury or inflammation travel to spinal cord then brain Physical dependence body physiologically accustomed to opioid therapy and suffers withdrawal symptoms if it is removed or rapidly decreased Cutaneous stimulation massage; heat/cold therapy; acupressure; TENS unit chronic pain persists or recurrent greater than 3 months endorphins powerful pain blocking chemicals; prolonged analgesic effects; produce euphoria Breakthrough pain temporary flare- up of mod.- severe pain that occurs with ATC (around the clock) meds BP, O2 sat, RR Pertinent VS to monitor with PCA or Epidural analgesia Phantom pain does not have an identifiable physiologic or pathologic cause; ex. amputation Nociplastic pain chronic primary pain; ex. cancer or fibromyalgia; not classified as nocicpetive or enuropathic transduction activation of pain receptors enkephalins inhibit release of substance P to reduce pain sensation prostaglandins send additional pain stimuli to CNS NSAIDs Contraindicated with bleeding disorders, probable infections and pregnancy >/+ 20 weeks EMLA cream cover w/ occlusive dressing 1hr prior to procedure for local pain relief modulation process by which the sensation of pain is inhibited or modified addiction chronic, relapsing brain disease; compulsive drug seeking Hypnosis produces a subconscious state accomplished by suggestions made by hypnotist acute pain rapid in onset; mild to severe; protective in nature Pain tolerance max intensity of stimulus that produces pain a person is willing to accept Pasero Opioid- Induced Sedation Scale used to assess respiratory depression S1234 Opioid analgesic Assess for respiratory depression with these meds; reversal Narcan (naloxone) 30 degrees HOB elevation for epidural analgesia bradykinin vasodilator; triggers release of histamine; assists in inflammation s/s FLACC pain scale for 2 months to 7 years serotonin stimulate smooth muscles, inhibit gastric secretion; cause vasoconstriction Acetaminophen viewed as one of the safest & best- tolerated analgesics pain it is what pt says it is substance P sensitizes receptors on nerves to feel pain; increase nerve firing rate PCA pump to be operated by patient only CRIES pain scale used for neonates (0-6mo.) nociceptors peripheral/pain receptors; respond to selective stimuli Multimodal analgesic therapy combines 2+ classes of analgesics that target different sites in peripheral and CNS to maximize pain relief pain threshold min. intensity of a stimulus that is perceived as painful Tolerance body becomes accustomed to opioid and need larger doses Postherpetic neuralgia follows acute CNS infection (ex. herpes zoster - shingles) Gate Control Theory pain is believed to be controlled by closing the gating mechanism in the spinal cord Nociceptive pain represented by normal pain process Visceral pain poorly localized; originates in thorax, cranium and abdomen; usually r/t disease Oral (po) Preferred route of medication for cancer pain Intractable pain resistant to therapy; no relief from interventions nocebo harmful or undesirable response from placebo Somatic pain diffuse; originate in tendons, ligaments, bones blood vessels or nerves referred pain pain originates in one part of body but perceived in area distant from point of origin Sharp quality of pain that is stabbing and intense Neuropathic pain caused by lesion or disease of peripheral or central somatosensory nervous system Diversion any act that results in a controlled drug not reaching the prescribed pt placebo sham med or procedure designed and known to not be of any therapeutic clinical value Cutaneous pain superficial; involves skin or SQ tissue; ex. paper cut transmission pain sensation from site of injury or inflammation travel to spinal cord then brain Physical dependence body physiologically accustomed to opioid therapy and suffers withdrawal symptoms if it is removed or rapidly decreased Cutaneous stimulation massage; heat/cold therapy; acupressure; TENS unit chronic pain persists or recurrent greater than 3 months endorphins powerful pain blocking chemicals; prolonged analgesic effects; produce euphoria Breakthrough pain temporary flare- up of mod.- severe pain that occurs with ATC (around the clock) meds BP, O2 sat, RR Pertinent VS to monitor with PCA or Epidural analgesia Phantom pain does not have an identifiable physiologic or pathologic cause; ex. amputation
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chronic primary pain; ex. cancer or fibromyalgia; not classified as nocicpetive or enuropathic
activation of pain receptors
inhibit release of substance P to reduce pain sensation
send additional pain stimuli to CNS
Contraindicated with bleeding disorders, probable infections and pregnancy >/+ 20 weeks
cover w/ occlusive dressing 1hr prior to procedure for local pain relief
process by which the sensation of pain is inhibited or modified
chronic, relapsing brain disease; compulsive drug seeking
produces a subconscious state accomplished by suggestions made by hypnotist
rapid in onset; mild to severe; protective in nature
max intensity of stimulus that produces pain a person is willing to accept
used to assess respiratory depression S1234
Assess for respiratory depression with these meds; reversal Narcan (naloxone)
HOB elevation for epidural analgesia
vasodilator; triggers release of histamine; assists in inflammation s/s
pain scale for 2 months to 7 years
stimulate smooth muscles, inhibit gastric secretion; cause vasoconstriction
viewed as one of the safest & best-tolerated analgesics
it is what pt says it is
sensitizes receptors on nerves to feel pain; increase nerve firing rate
to be operated by patient only
pain scale used for neonates (0-6mo.)
peripheral/pain receptors; respond to selective stimuli
combines 2+ classes of analgesics that target different sites in peripheral and CNS to maximize pain relief
min. intensity of a stimulus that is perceived as painful
body becomes accustomed to opioid and need larger doses
follows acute CNS infection (ex. herpes zoster - shingles)
pain is believed to be controlled by closing the gating mechanism in the spinal cord
represented by normal pain process
poorly localized; originates in thorax, cranium and abdomen; usually r/t disease
Preferred route of medication for cancer pain
resistant to therapy; no relief from interventions
harmful or undesirable response from placebo
diffuse; originate in tendons, ligaments, bones blood vessels or nerves
pain originates in one part of body but perceived in area distant from point of origin
quality of pain that is stabbing and intense
caused by lesion or disease of peripheral or central somatosensory nervous system
any act that results in a controlled drug not reaching the prescribed pt
sham med or procedure designed and known to not be of any therapeutic clinical value
superficial; involves skin or SQ tissue; ex. paper cut
pain sensation from site of injury or inflammation travel to spinal cord then brain
body physiologically accustomed to opioid therapy and suffers withdrawal symptoms if it is removed or rapidly decreased
massage; heat/cold therapy; acupressure; TENS unit
persists or recurrent greater than 3 months
powerful pain blocking chemicals; prolonged analgesic effects; produce euphoria
temporary flare-up of mod.-severe pain that occurs with ATC (around the clock) meds
Pertinent VS to monitor with PCA or Epidural analgesia
does not have an identifiable physiologic or pathologic cause; ex. amputation
