Pain and Pain Relief - a Brief Introduction Dr. Reino Pöyhiä, MD, PhD Consultant in Anaesthesiology Special Competence in Pain Medicine, Cardiac Anaesthesia and Palliative Medicine, Finland Associate Professor of Anaesthesiology and Palliative Medicine, Helsinki and Turku University, Finland Head of the Dept of Anaesthesia, Helsinki Univ Central Hosp
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Pain and Pain Relief - a Brief Introduction Dr. Reino Pöyhiä, MD, PhD Consultant in Anaesthesiology Special Competence in Pain Medicine, Cardiac Anaesthesia.
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Pain and Pain Relief- a Brief Introduction
Dr. Reino Pöyhiä, MD, PhDConsultant in AnaesthesiologySpecial Competence in Pain Medicine, Cardiac Anaesthesia and Palliative Medicine, FinlandAssociate Professor of Anaesthesiology and Palliative Medicine, Helsinki and Turku University, FinlandHead of the Dept of Anaesthesia, Helsinki Univ Central Hosp
What is pain?
• PAIN is an unpleasant sensory AND emotional experience associated with actual or potential tissue damage OR described in terms of such damage
• IASP = International Association for the Study of Pain 1979
How to improve postop pain relief?1. Assessment of pain2. Protocols
- must be composed locally – by an expert group- each patient should get NSAID/paracetamol at fixed intervals- tramadol PRN after minor surgery- pethidin or oral morphine PRN
3. Individual tailoring- if preoperative pain, consider carbamazepine preoperatively- if protocols fail, ketamine im or orally in small doses- intercostal block with bupivacaine for cholecystectomy- wound injection of bupivacaine
Chronic pain
What can chronic pain cause?
– depression– insomnia– mental irritation– helplesness– loss of apetite– loss of social contacts↓– libido ↓– human value ↓– genetic changes in the body ?
Pain in HIV/AIDSOral/skin Visceral Somatic Neuropathy/Headache
Summary• pain analysis is important• record the intensity and influence of pain before and
after treatments• treatments of pain should be based on pain
mechanisms – multimodal analgesia• undertreatment of pain is common
– may severe effects on recovery• defined protocols may improve postop pain relief• WHO cancer pain relief programme is highly effective• don´t be afraid of opioids• pain relief can be increased with supportive methods