1. PAIN CONTROL IN SURGICAL PATIENT PRESENTED BY DR AZZA SERRY

2. LEARNING OBJECTIVES PAIN DEFINITION AND TYPES PHYSIOLOGICAL EFFECTS OF PAIN PAIN PATHWAY PAIN ASSESSMENT SCALE PAIN ANALGESIA

3. PAIN It is an unpleasant sensory and emotional experience associated with tissue damage It is a protective mechanism warns the body of something that requires attention.

4. TYPES OF PAIN Acute pain Chronic pain

5. ACUTE PAIN It follows the injury,resolves when body injury heals, associated with tachycardia, hypertension, pallor. Examples, broken leg,tooth infection

6. CHRONIC PAIN It is a persistent pain lasting for more than three months, that can disrupt sleep, mood and normal living activities, not associated with sympathetic hyperactivity. Example : joint pain, back pain.

7. PHYSIOLOGICAL EFFECTS OF PAIN Hypertension, ↑ heart rate ↑ respiratory rate, splint chest wall → atelectasis Anxiety, sleeplessness Decrease mobility ( increase risk of deep venous thrombosis) Urinary retention,

8. PAIN PATHWAY

9. PAIN ASSESSMENT SCALES VERBAL SCALE : None, mild, mild, severe VISUAL ANALOGUE SCORE : Ranging from worst pain ever (10 ), to no pain at all ( 0 ).

11. PAIN ANALGESIA ANALGESIA IS ABSENCE OF PAIN FOLLOW ANALGESIC LADDER

12. TYPES SIMPLE ANALGESICS OPIODS

13. SIMPLE ANALGESICS Paracetamol mild pain analgesic, antipyretic, oral, intravenous Overdose → liver failure

14. NSAIDS NON –STEROIDAL ANTI- INFLAMMATORY DRUGS Ibuprofen, diclofenac Reduce pain sensation, reduce inflammation that accompanies and worsens pain Used in mild to moderate pain, oral, injectable Increase bleeding tendency, nephrotoxic, bronchospasm.

15. OPIOID ANALGESICS Morphine, fentanyl, analgesia, euphoria, cerntral and peripheral receptors ( opiate receptors ). Used in severe pain, oral, injectable, Can cause respiratory depression, nausea,vomiting, hypotension,addiction.