chapter 3 - pain and its management

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ain and Its ain and ItsManagementanagement

Chapter 3



PainA sensation of hurting caused by injury,

disease, or functional disorder

Suffering mental or physical distress causedby great anxiety, anguish, grief,disappointment, or other psychological oremotional stimuli.

American Pain Society's Definition- “anunpleasant sensory & emotionalexperience associated with actual orpotential tissue damage”.



Factors Influencing How We

Experience PainEarly experience of pain – increases with

each painful event

Cultural backgrounds – culture not aninfluence on perception of pain, but is onhow one responds

Anxiety & depression – longer the duration

of pain, the greater the occurrence of depression.

Age – no difference in pain perception.

Sex – female experience more pain



Purpose of PainWarning signal that tissue damage is occurring.



Pain AssessmentP = place of the pain

A = amount of pain rated on a 1-10 scale orsmiley face

I = interactions; what makes the painworse

N = neutralizers; what lessens the pain



Placebo PhenomenonPlacebo – a medication that produces an effect

in a client because of its intent rather thanbecause of its specific physical or chemical

properties.Placebo effects results from the natural

production of endorphins and enkephalins.



Surgery to Block PainNeurotomy – dissection or division of a nerve

Cordotomy – surgical division of one or more of the lateral nerve pathways emerging from thespinal cord

Hypophysectomy – removal of pituitary gland

Removal of any causative factor



Alternative Pain Control

TherapiesBiofeedback –gaining voluntary control over

normally involuntary physiologic functions

Relaxation – modification of muscle tensionImagery – mental images of comfort &

relaxation

Hypnosis – induced state similar to sleep

Transcutaneous Electrical Nerve Stimulation(TENS) – electrical impulses to large nervefibers



Alternative Therapies,

cont’dMassage – manipulation, methodical pressure,

friction and kneading of the body

Humor, Laughter, & Play – distracts, reducestension, increases endorphins

Music – sooths & distracts

Acupuncture – slight pricking of skin with

needles



Alternative Therapies,

cont’dAromatherapy – use of essential oils from

plants and herbs

Therapeutic Touch – replenishing of client’senergy field by hand motion

Yoga – mind & body unity with physicalpostures, relaxation and regulation of breathing



Pain TreatmentsAnalgesicsOpioids (narcotics)

Codeine, morphine, fentanyl, butorphanol

Nonopioids Acetaminophen (Tylenol) Nonsteroidal anti-inflammatory drugs (NSAIDS)

Anesthetics

Anti-inflammatory agentsSteroidsNonsteroidal anti-inflammatory drugs

(NSAIDS)

Adjuvant analgesics – those not usually



Paradign Shift on Pain

TreatmentOld Paradign

Health-care providers who prescribe long termopioids are similar to drug dealers

Long term use of pain medication is unsafe and can

cause addition.

New ParadignOpioid treatment is safe and effective if monitored

by physician

Patient Controlled analgesicsPCA Pump – patient can administer his/her own pain

medication



“ ,ain is an e ne rg y mo ns te r e g iv e it the po we r to h ur t

.s A n we t ak e th at pow er

—wa y de pe nd ing on h ow w e.ho os e to vie w o ur sel ve s

,ll pai n i s re al b ut y ou can

. ”ha ng e yo ur r ea li ty

a vi d Bl ac k

chapter 3 - pain and its management

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