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