Pain: Difference between revisions
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Analgesia is based on a three steps of increasingly strong pain relief. The decision to go to the next level of pain relief is based on whether the pain persists/increases whilst under each treatment. | Analgesia is based on a three steps of increasingly strong pain relief. The decision to go to the next level of pain relief is based on whether the pain persists/increases whilst under each treatment. | ||
*'''Step 1 - non-opioid''': this is generally [[paracetamol]] or an [[NSAID]] (e.g. [[ibuprofen]]). | *'''Step 1 - non-opioid''': this is generally [[paracetamol]] or an [[NSAID]] (e.g. [[ibuprofen]]). Regularly rather than [[prn]]. | ||
*'''Step 2 - weak opioid''': usually, this will be [[codeine]] +/- a non-opioid. | *'''Step 2 - weak opioid''': usually, this will be [[codeine]] +/- a non-opioid. | ||
*'''Step 3 - strong opioid''': generally [[morphine]] +/- an opioid | *'''Step 3 - strong opioid''': generally [[morphine]] +/- an opioid | ||
Sometimes, in patients with severe pain, they don't respond to morphine, or not after a certain level. In these situations, you can use [[methadone]] or [[ketamine]], which can often alleviate pain where other methods have failed. | Sometimes, in patients with severe pain, they don't respond to morphine, or not after a certain level. In these situations, you can use [[methadone]] or [[ketamine]], which can often alleviate pain where other methods have failed. | ||
Revision as of 13:23, 11 December 2009
Ow, that hurts!
Pain is very common. It means something is hurting.
Why does it hurt?
There are many many causes of physical pain, but unless your ex-wife runs you over in a truck, love is not one of them. It is one of the most common symptoms, and probably leads to about a jillion days off work each year.
What should I know?
The biggest department that deals with pain is Palliative care. Pain control is guided by the WHO Analgesic Ladder.:
Analgesia is based on a three steps of increasingly strong pain relief. The decision to go to the next level of pain relief is based on whether the pain persists/increases whilst under each treatment.
- Step 1 - non-opioid: this is generally paracetamol or an NSAID (e.g. ibuprofen). Regularly rather than prn.
- Step 2 - weak opioid: usually, this will be codeine +/- a non-opioid.
- Step 3 - strong opioid: generally morphine +/- an opioid
Sometimes, in patients with severe pain, they don't respond to morphine, or not after a certain level. In these situations, you can use methadone or ketamine, which can often alleviate pain where other methods have failed.