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Pain
McCaffery defines pain as
“Whatever the experiencing person says it is,
existing whenever he/she says it does.”
Types
I. Based on duration
•
•
•
•

Acute pain
Chronic pain
Chronic malignant pain
Chronic non-malignant pain
II. Based on the origin
• Cutaneous pain
• Deep somatic pain
• Visceral pain
III. Based on nature of pain
•
•
•
•
•

Radiating pain
Referred pain
Intractable pain
Neuropathic pain
Phantom Limb
Mnemonics for pain assessment
OLD CART
• O- Onset
• L- Location
• D- Duration
• C- Characteristics
• A- Aggravating factors
• R- Radiation
• T- Treatment

PQRST
• P- Provoked
• Q- Quality
• R- Region/Radiation
• Severity
• Timing
Pain Management
I. Pharmacologic pain management

• Opioid analgesics
• NSAID’s
• Adjuvant analgesics
• Patient Controlled analgesia
• Family controlled analgesia
II. Non-pharmacologic management
1. Physical interventions
a. Cutaneous stimulation

•
•
•
•

Massage
Hot or cold application
Accupressure
Contralateral stimulation

b. Immobilization

a. Transcutaneous electrical nerve stimulation (TENS)
2. Mind Body interventions
• Distraction
–
–
–
–
–
–
–
–
–
–

Visual
Auditory
Tactile
Intellectual
Reading
Watching TV
Humour
Massage
Holding a pet/ toy
Crossword puzzles
•
•
•
•

Meditation
Biofeedback
Hypnosis
Therapeutic touch
III. Non-pharmacologic invasive therapies
•
•
•
•
•
•

Nerve block
Cordotomy
Rhizotomy
Neurectomy
Sympathectomy
Spinal cord stimulation
Thank you

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Pain

  • 2. McCaffery defines pain as “Whatever the experiencing person says it is, existing whenever he/she says it does.”
  • 3. Types I. Based on duration • • • • Acute pain Chronic pain Chronic malignant pain Chronic non-malignant pain
  • 4. II. Based on the origin • Cutaneous pain • Deep somatic pain • Visceral pain
  • 5. III. Based on nature of pain • • • • • Radiating pain Referred pain Intractable pain Neuropathic pain Phantom Limb
  • 6. Mnemonics for pain assessment OLD CART • O- Onset • L- Location • D- Duration • C- Characteristics • A- Aggravating factors • R- Radiation • T- Treatment PQRST • P- Provoked • Q- Quality • R- Region/Radiation • Severity • Timing
  • 7. Pain Management I. Pharmacologic pain management • Opioid analgesics • NSAID’s • Adjuvant analgesics • Patient Controlled analgesia • Family controlled analgesia
  • 8. II. Non-pharmacologic management 1. Physical interventions a. Cutaneous stimulation • • • • Massage Hot or cold application Accupressure Contralateral stimulation b. Immobilization a. Transcutaneous electrical nerve stimulation (TENS)
  • 9. 2. Mind Body interventions • Distraction – – – – – – – – – – Visual Auditory Tactile Intellectual Reading Watching TV Humour Massage Holding a pet/ toy Crossword puzzles
  • 11. III. Non-pharmacologic invasive therapies • • • • • • Nerve block Cordotomy Rhizotomy Neurectomy Sympathectomy Spinal cord stimulation