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pain

Pain

Journal

Definition

Pain is a multidimensional experience with an affective component: the unpleasantness.

Epidemiology

Pain is the most common reason patients seek medical care. Pain has sensory and emotional components

Classification

Often classified as acute or chronic.

Acute pain is frequently associated with anxiety and hyperactivity of the sympathetic nervous system (eg, tachycardia, increased respiratory rate and BP, diaphoresis, dilated pupils).

Chronic pain

see Neuropathic pain

see Back pain

see Leg pain

Abdominal pain

The anterior cingulate cortex (ACC) is a structure involved in the affective component, and targeting it may relieve patients' pain.

Treatment

Pain management following major intracranial surgery is often limited by a presumed lack of need and a concern that opioid analgesics will adversely affect postoperative outcome and interfere with the neurologic examination. Nevertheless, evidence in adults is accumulating that these patients suffer moderate to severe pain, and this pain is often under-treated.

In traumatic brain injury

Many patients with a traumatic brain injury (TBI) are unable to self-report their pain in the intensive care unit (ICU) because of altered levels of consciousness (LOC), mechanical ventilation, and/or aphasia 1).

In nonverbal populations, use of behaviors suggestive of pain (a.k.a pain behaviors) such as grimacing, increased muscle tension, protective movements, and noncompliance with the ventilator is recommended for pain assessment 2) 3).

Books

Integrating Pain Treatment into Your Spine Practice

This book fills the gap in knowledge and patient care by showing spine surgeons how to integrate pain management techniques into their practice. The first of its kind, Integrating Pain Treatment into Your Spine Practice is in tune with current efforts by major neurosurgical and neuromodulation societies and leading manufacturers of neuromodulation equipment to educate spine surgeons on the management of their patients’ post-surgical pain.

Designed as an all-in-one volume, this book explains how to identify candidates for pain treatment and when to refer them to specialists. It also presents “how-to” clinical information on approaches to managing pain, from the medical to the interventional and provides practical business guidance on coding and reinforcement.

1)
J. A. Young, “Pain and traumatic brain injury,” Physical Medicine & Rehabilitation Clinics of North America, vol. 17, no. 2, pp. 145–163, 2006.
2)
J. Barr, G. L. Fraser, K. A. Puntillo, et al., “Clinical practice guidelines for the management of pain, agitation, and delirium in adult ICU patients,” Critical Care Medicine, vol. 41, no. 1, pp. 263–306, 2013.
3)
Herr, P. J. Coyne, M. McCaffery, R. Manworren, and S. Merkel, “Pain assessment in the patient unable to self-report: position statement with clinical practice recommendations,” Pain Management Nursing, vol. 12, no. 4, pp. 230–250, 2011.
pain.txt · Last modified: 2017/01/22 19:34 (external edit)