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Pain Shangrong Li, MD Anesthesiology department Third hospital Sun Yat-sen University
Content ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10
Definition of Pain ,[object Object],05/26/10
Definition of Pain ,[object Object],05/26/10 “ Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.” IASP (1979) ,[object Object]
Content ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10
05/26/10 TRPV  辣椒素受体 TREK  钾离子通道 ASIC  酸敏感离子通道 DRASIC ACIC3 MDEG 退化蛋白通道 TRPM8  冷受体 8
05/26/10 Somatosensory nerve fibers
Somatosensory nerve fibers 05/26/10 Fiber type Fiber characteristics Speed of conduction Associated with Aβ Large, myelinated 30-70 m/sec Mechanical stimuli Aδ Small, myelinated 12-30 m/sec Cold, fast pain, mechanical stimuli C Small, unmyelinated 0.5-2 m/sec Slow, heat, cold, mechanical stimuli
05/26/10
05/26/10
Pain Pathways 05/26/10
Content ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10
Categories of Pain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10
Categories of Pain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10
Measuring Pain  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10 No one tool is suitable for all situations
Ranking ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10
05/26/10
Content ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10
05/26/10 Opioids (Narcotics, Narcotic analgesics)
05/26/10 Blooming poppy flower
Opioid Receptor Subtypes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10
Agonist and antagonist ,[object Object],[object Object],[object Object],05/26/10
Pharmacological Effects of Morphine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10
Other properties ,[object Object],[object Object],[object Object],05/26/10
Clinical use ,[object Object],[object Object],[object Object],[object Object],05/26/10
Naloxone   ,[object Object],[object Object],[object Object],[object Object],05/26/10
05/26/10 NSAIDs
Pharmaceutical  effects ,[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10
Mechanism  ,[object Object],05/26/10
Charataristics  ,[object Object],[object Object],[object Object],[object Object],05/26/10
classiify ,[object Object],[object Object],05/26/10
Content ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10
Nerve block ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10
Local anesthetics ,[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10
Mechanism ,[object Object],[object Object],05/26/10
Methods of administration ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10
Patient Controlled Analgesia  (PCA) Infusions 05/26/10
Patient controlled analgesia ,[object Object],[object Object],[object Object],05/26/10
05/26/10
PCA : settings ,[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10
05/26/10 Acute pain
Importance of pain control ,[object Object],[object Object],[object Object],[object Object],05/26/10
Postoperative pain management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10
05/26/10 Labor Pain
Nature of Labor Pain –  1 st  Stage ,[object Object],[object Object],[object Object],05/26/10
Nature of Labor Pain –  2 nd  Stage  ,[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10
Lumbar Epidural Analgesia ,[object Object],[object Object],[object Object],[object Object],05/26/10
05/26/10 Chronic pain
05/26/10 Low back pain (LBP)
Epidemiology ,[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10
Notice ,[object Object],[object Object],[object Object],05/26/10
Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10
05/26/10 Cancer pain
incidence ,[object Object],[object Object],05/26/10
consequences ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10
assessment ,[object Object],[object Object],[object Object],[object Object],05/26/10
05/26/10 Pain Physical   symptoms Psychological Social Cultural Spiritual Suffering Woodruff, 1999
WHO Analgesic Ladder ,[object Object],[object Object],[object Object],[object Object],05/26/10
05/26/10 Mild pain (0-3) Moderate pain (4-6) Severe pain (7-10) By the mouth By the clock By the ladder Acetaminophen Codeine Morphine WHO pain ladder
Other treatment ,[object Object],[object Object],05/26/10
Questions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],05/26/10
[object Object],05/26/10
05/26/10 Thank you for listening

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