WELCOME

PAINPREPARED BY

ASEEM.B,MBA,MSN,PGDHA

ASSISTANT PROFESSORSP FORT COLLEGE OF

NURSINGTHIRUVANANTHAPURAM

DEFINITION PAINPAIN IS A LOCALISED PHYSICAL

SUFFERING ASSOCIATED WITH BODILY DISORDER. - (WEBSTERS DICTIONARY)

“ PAIN IS A BASIC BODILY SENSATION INDUCED BY A NOXIUS STIMULUS

RECEIVED BY NAKED NERVE ENDINGS,CHARACTERISED BY PHYSICAL DISCOMFORT AND TYPICALLY LEADING

TO EVASIVE ACTION ”

IT IS DEFINED AS THE UNIVERSALLY EMOTIONAL AND SENSORY EXPERIENCE THAT OCCURS IN RESPONSE TO TISSUE TRAUMA, REFFERED TO AS THE FIFTH VITAL SIGN.

TYPES – ACUTE AND CHRONIC ACUTE – Mild To Severe Pain Lasting Less

Than 6 Months, Usually Associated With Specific Injury.It Involves Sympathetic Ns.

CHRONIC- Mild To Severe Pain Lasting Morethan 6 Months.Associated With Parasympathetic Nervous System

FACTORS AFFECTING PAIN AGE GENDER CULTURE MEANING OF PAIN ATTENTION ANXIETY FATIGUE PREVIOUS EXPERIENCE

FACTORS CONTD- FAMILY AND SOCIAL SUPPORT PLACEBO EFFECT DEPRESSION

PAIN PROCESS TRANSDUCTION(noxious stimuli causes cell

damage with the release of chemicals like serotonin,histamin, prostaglandin)

TRANSMISSION(action potential continues from site of injury to spinal cord)

PERCEPTION(conscious experience of pain)

MODULATION(neurons oroginating in the brainstem descend to the spinal cord and release substance that inhibit pain impulses)

PAIN CLASSIFICATIONACCORDING TO DURATION ACUTE PAIN CHRONIC PAIN CANCER RELATED PAIN

ACCORDING TO LOCATION EG: PELVIC PAIN,CHEST PAIN,HEAD

ACHE etc

ACCORDING TO ETIOLOGY

EG : BURN PAIN, NEURALGIA

REFERRED PAIN-PAIN THAT IS PERCEIVED IN AN AREA DISTANT FROM THE POINT OF ORIGIN.

EG :MI PAIN

COMMON RESPONSES TO PAIN

BEHAVIOURAL RESPONSES

PHYSIOLOGIC RESPONSES

PSYCHOLOGIC RESPONSES

BEHAVIOURAL RESPONSES GRIMACING MOURNING(state of sorrow) CRYING RESTLESSNESS PROTECTING THE AREA AND REFUSING

TO MOVE MOVING AWAY FROM THE PAINFUL

STIMULI

PHYSIOLOGIC RESPONSES

SYMPATHETIC RESPONSES INCREASED BLOOD PRESSURE INCREASED PULSE & RESPIRATORY

RATEPUPIL DILATIONMUSCLE TENSION & RIGIDITYPALLOR INCREASED BLOOD GLUCOSE INCREASED OUTPUT

PHYSIOLOGIC RESPONSES CONTD

PARASYMPATHATIC RESPONSES NAUSEA/VOMITTING FAINTING OR UNCONSCIOUSNESS DECREASED BP RAPID & IRREGULAR BREATHING

PSYCHOLOGIC RESPONSES

RESTLESSNESS ANXIETY DEPRESSION FEAR ANGER ANOREXIA FATIGUE POWERLESSNESS HOPELESSNESS

CHARACTERISTICS OF PAIN INTENSITY(severity) TIMING LOCATION QUALITY – burning, numbing, shooting,

stabbing, itchy sensation.

TREATMENT PHARMACOLOGICAL TREATMENT

NON PHARMACOLOGICAL TREATMENT

SURGICAL INTERVENTION

PHARMACOLOGICAL TREATMENT

NON NARCOTIC AGENTSACETAMINOPHEN,ASPIRIN

NSAIDSIBUPROFEN, NAPROXEN, KETORALAC etc

NARCOTIC ANALGESICSMORPHINE SULPHATE, FENTANYL,

MEPERIDONE, CODEINE etc

ADJUVANTSAMITRIPTYLINE, HYDROXYZINE, DIAZEPAM,

CHLORPROMAZINE

NON PHARMACOLOGICAL INTERVENTIONS

ACUPUNCTURE RELAXATION TECHNIQUE GUIDED IMAGERY DISTRACTION MUSIC BIOFEEDBACK HYPNOSIS TENS( TRANS CUTANEOUS ELECTRICAL

NERVE STIMULATION )

SURGICAL INTERVENTION CORDOTOMY :

IT IS THE DIVISION OF CERTAIN TRACTS OF THE SPINAL CORD

RHIZOTOMY

THE SENSORY NERVE ROOTS ARE DESTROYED WHERE THEY ENTER THE SPINAL CORD

PAIN SCALES NUMERICAL SCALE DESCRIPTIVE SCALE PAIN VISUAL ANALOG OUCHER SCALES WONG BAKER SCALES

THANK YOU