PAIN CONTROL IN SURGICAL PATIENT

PRESENTED BY

DR AZZA SERRY

LEARNING OBJECTIVES

• PAIN DEFINITION AND TYPES

• PHYSIOLOGICAL EFFECTS OF PAIN

• PAIN PATHWAY

• PAIN ASSESSMENT SCALE

• PAIN ANALGESIA

PAIN • It is an unpleasant sensory and emotional experience associated with tissue damage

• It is a protective mechanism warns the body of something that requires attention .

TYPES OF PAIN

•Acute pain

•Chronic pain

ACUTE PAIN

•It follows the injury ,resolves when body injury heals , associated with tachycardia , hypertension , pallor .

•Examples , broken leg ,tooth infection

CHRONIC PAIN

• It is a persistent pain lasting for more than three months, that can disrupt sleep, mood and normal living activities, not associated with sympathetic hyperactivity .

•Example : joint pain , back pain .

PHYSIOLOGICAL EFFECTS OF PAIN

• Hypertension, ↑ heart rate

•↑ respiratory rate, splint chest wall → atelectasis

•Anxiety , sleeplessness

•Decrease mobility ( increase risk of deep venous thrombosis)

•Urinary retention ,

PAIN PATHWAY

PAIN ASSESSMENT SCALES

• VERBAL SCALE :

• None , mild , mild , severe

• VISUAL ANALOGUE SCORE :

• Ranging from worst pain ever (10 ) , to no pain at all ( 0 ) .

PAIN ANALGESIA

• ANALGESIA IS ABSENCE OF PAIN

• FOLLOW ANALGESIC LADDER

TYPES

•SIMPLE ANALGESICS

•OPIODS

SIMPLE ANALGESICS

• Paracetamol mild pain analgesic , antipyretic , oral , intravenous

• Overdose → liver failure

NSAIDSNON –STEROIDAL ANTI- INFLAMMATORY DRUGS

• Ibuprofen, diclofenac

•Reduce pain sensation, reduce inflammation that accompanies and worsens pain

•Used in mild to moderate pain, oral , injectable

• Increase bleeding tendency, nephrotoxic, bronchospasm.

OPIOID ANALGESICS

•Morphine, fentanyl, analgesia, euphoria, cerntral and peripheral receptors ( opiate receptors ) .

• Used in severe pain, oral, injectable,

• Can cause respiratory depression , nausea ,vomiting , hypotension ,addiction .