1
Pain Management
Objectives of the Lesson:
● Identify the fundamental concepts of pain.
● Distinguish between the types of pain.
● Describe the four processes of nociception.
● Explain underlying mechanisms of neuropathic pain.
● Identify methods to perform a pain assessment.
● List the three groups of analgesics agents
● Use the nursing process as a framework for the care of patients with pain.
Definition of pain
The American Pain Society (2008) defines pain as “an unpleasant sensory and
emotional experience associated with actual or potential tissue damage”. This
definition describes pain as a complex phenomenon that can impact a person's
psychosocial, emotional, and physical functioning. All accepted guidelines
consider the patient’s report to be the most reliable indicator of pain and the most
essential component of pain assessment.
Effects of Pain
Pain the affects individuals of every age, sex, race and socioeconomic class. It is
the primary reason people seek health care and one of the most common conditions
that nurses treat. (International Association for the Study of Pain, 2011).
Unrelieved pain has the potential to affect every system in the body and cause
numerous harmful effects, and may last a person’s lifetime.
Keywords:
Nursing care
, 2
Types of Pain
➔ Acute Pain: It is caused by injury, surgery, illness, trauma, or painful
medical procedures. It has a relatively short duration, less than 6 months,
and resolves with a normal healing process.
➔ Chronic Pain: It is ongoing pain and usually lasts longer than 6 months. This
type of pain continues even after the injury or illness that caused it has
healed. It can persist throughout the course of a person’s life.
➔ Nociceptive (Physiologic) Pain: It refers to the normal functioning of the
physiological system that leads to the perception of noxious stimuli (tissue
injury) as being painful.
➔ Neuropathic (Pathophysiologic) Pain: It is pathologic and results from
abnormal processing of sensory input by the nervous system as a result of
damage to the peripheral or central nervous system or both.
The Four processes of Nociceptive Pain:
1. Transduction: It refers to the process by which noxious stimuli, such as burn,
activate primary afferent neurons called nociceptors, which are located
throughout the body in the skin, subcutaneous tissue, visceral (organs) and
somatic (musculoskeletal) structures (Pasero & Portenoy, 2011).
These neurons have the ability to respond selectively to the noxious stimuli
generated as a result of tissue damage from mechanical (incision, tumor
growth), chemical (toxins, chemotherapy), thermal (burn, frostbite), and
infectious sources. Noxious stimuli cause the release of a number of
excitatory compounds (serotonin, bradykinin, histamine, substance P, and
prostaglandins), which move pain along the pain pathway.
Prostaglandins are lipid compounds that initiate inflammatory responses that
increase tissue swelling and pain at the site of injury. They are formed when
Nursing care
Pain Management
Objectives of the Lesson:
● Identify the fundamental concepts of pain.
● Distinguish between the types of pain.
● Describe the four processes of nociception.
● Explain underlying mechanisms of neuropathic pain.
● Identify methods to perform a pain assessment.
● List the three groups of analgesics agents
● Use the nursing process as a framework for the care of patients with pain.
Definition of pain
The American Pain Society (2008) defines pain as “an unpleasant sensory and
emotional experience associated with actual or potential tissue damage”. This
definition describes pain as a complex phenomenon that can impact a person's
psychosocial, emotional, and physical functioning. All accepted guidelines
consider the patient’s report to be the most reliable indicator of pain and the most
essential component of pain assessment.
Effects of Pain
Pain the affects individuals of every age, sex, race and socioeconomic class. It is
the primary reason people seek health care and one of the most common conditions
that nurses treat. (International Association for the Study of Pain, 2011).
Unrelieved pain has the potential to affect every system in the body and cause
numerous harmful effects, and may last a person’s lifetime.
Keywords:
Nursing care
, 2
Types of Pain
➔ Acute Pain: It is caused by injury, surgery, illness, trauma, or painful
medical procedures. It has a relatively short duration, less than 6 months,
and resolves with a normal healing process.
➔ Chronic Pain: It is ongoing pain and usually lasts longer than 6 months. This
type of pain continues even after the injury or illness that caused it has
healed. It can persist throughout the course of a person’s life.
➔ Nociceptive (Physiologic) Pain: It refers to the normal functioning of the
physiological system that leads to the perception of noxious stimuli (tissue
injury) as being painful.
➔ Neuropathic (Pathophysiologic) Pain: It is pathologic and results from
abnormal processing of sensory input by the nervous system as a result of
damage to the peripheral or central nervous system or both.
The Four processes of Nociceptive Pain:
1. Transduction: It refers to the process by which noxious stimuli, such as burn,
activate primary afferent neurons called nociceptors, which are located
throughout the body in the skin, subcutaneous tissue, visceral (organs) and
somatic (musculoskeletal) structures (Pasero & Portenoy, 2011).
These neurons have the ability to respond selectively to the noxious stimuli
generated as a result of tissue damage from mechanical (incision, tumor
growth), chemical (toxins, chemotherapy), thermal (burn, frostbite), and
infectious sources. Noxious stimuli cause the release of a number of
excitatory compounds (serotonin, bradykinin, histamine, substance P, and
prostaglandins), which move pain along the pain pathway.
Prostaglandins are lipid compounds that initiate inflammatory responses that
increase tissue swelling and pain at the site of injury. They are formed when
Nursing care
