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Symptoms And Treatment Of Pain Management

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Pain Management

INTRODUCTION
Pain is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (Merskey 1994, IASP).
Acute pain is of recent onset and could be due to illness, injury or surgical procedures. If it persists beyond the time of healing, then it is termed as Chronic pain.
Physiological pain includes nociceptive or inflammatory pain; Pathological or mal-adaptive pain includes neuropathic pain. This classification could help in mechanism-based management of pain though both pains usually exist together in some proportion.
In critically ill surgical patients, pain can be complex and needs integrated multidisciplinary approach. Proper …show more content…

Various neuropeptides modulate the transmission of these signals in the spinal cord. Ascending spinal pathways project to the sensory cortex, while some of these pathways also tract to medulla and midbrain linked with homeostatic and autonomic responses as well as the emotional component of the pain. Descending projections inhibit the noxious control and modulate the pain response.

NEUROPLASTICITY OF PAIN
Rather than the pain pathways, pain specialists now talk about pain neuromatrix. Neuromatrix is a complex system formed due to pain memory, behaviour, cognition, environmental and genetic factors. This is a continuously evolving system based on the past and present events; both the input and output of this complex neuromatrix undergoes continuous plasticity.

WHY SHOULD ACUTE PAIN BE TREATED?
Pain causes sympathetic stimulation and increased heart rate, causes vasoconstriction and increased oxygen demand. It can impair lung function, cause myocardial ischaemia and reduce blood flow to other vital organs. Major laparotomies and thoracic surgeries reduce the functional residual capacity of lung and impair the coughing ability, predisposing to chest infections. Lack of diaphragmatic movements lead to atelectasis and pneumonia. Pain restricts mobility and increases chances of deep vein thrombosis.
Acute pain

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