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