Acute pain

Abstract

Postanaesthesia care units used to echo with cries of patients in pain after general anaesthesia. Each as-needed dose of analgesia was given only after permission of the surgeon or anaesthesiologist. Once conscious, patients were required to request each subsequent analgesic dose until hospital discharge. Not surprisingly, nearly half the patients who have an operation experience moderate to severe pain after surgery. Acute pain control has advanced dramatically and is now a field with dedicated texts, journals, and research. Despite improved surgical techniques that have transformed many operations into same-day procedures, inadequately controlled pain may still extend the length of hospital stay and predispose to expensive, time-consuming complications such as pneumonia. Recognition of economic and humanitarian benefits of pain control has prompted worldwide attention from professional groups, insurers, and governments. This paper describes the process of acute pain and measures to control it with drugs or non-pharmacological interventions. Even brief intervals of acute pain can induce long-term neuronal remodelling and sensitisation ("plasticity"), chronic pain, and lasting psychologial distress. Hence, acute pain and other types of pain (cancer-related or chronic) that are classified as distinct actually have many similarities.

Evaluation of Pain Pressure Threshold and Widespread Pain in Chronic Low Back Pain

“…Increased nociceptor sensitivity is expressed by spontaneous firing, enlargement of the neuronal receptive field, and decreased firing threshold (35,36), which is known as the peripheral sensitization-an initiative for pain. Effective changes in tissue sensitivity may develop immediately after injury and the resultant pain because of neurobiological influences (14,37). Then, they may be followed by pain in unrelated sites and persistent exaggerated pain outside of the neuro-anatomical sensory distribution of the primary lesion.…”

Effects of opioids on local anesthesia in the rat: a codeine and tramadol study

“…17 This highlights the growing need for drug development and technical associations that meet patients' expectations of comfort, so that they may continue to seek good oral healthcare.…”

A patient-based national survey on postoperative pain management in France reveals significant achievements and persistent challenges

“…The most frequent detected failings concern the information of the patient, limited pain evaluation, the under use of opioid and regional anesthesia techniques and inadequate organization. However, POP is a major concern for hospitalized patients [13] and may interfere with postoperative recover and increase postoperative morbidity [14]. Ad hoc evidenced-based guidelines for improving pain management, have been issued in several countries [4,43,50,51,63].…”