Patofisiologi Nyeri (Pain)

Abstract

ABSTRAKNyeri adalah pengalaman sensorik dan emosional yang tidak menyenangkan akibat kerusakan jaringan, baik aktual maupun potensial atau yang digambarkan dalam bentuk kerusakan tersebut.Mekanisme timbulnya nyeri didasari oleh proses multipel yaitu nosisepsi, sensitisasi perifer, perubahan fenotip, sensitisasi sentral, eksitabilitas ektopik, reorganisasi struktural, dan penurunan inhibisi. Antara stimulus cedera jaringan dan pengalaman subjektif nyeri terdapat empat proses tersendiri : tranduksi, transmisi, modulasi, dan persepsi.Rangsang nyeri diterima oleh nosiseptor di kulit dan visera. Sel yang nekrotik akan melepaskan K + dan protein intrasel yang dapat mengakibatkan inflamasi. Mediator penyebab nyeri akan dilepaskan. Leukotrien, prostatglandin E 2 , dan histamine akan mensensitisasi nosiseptor selain itu lesi jaringan juga mengaktifkan pembekuan darah sehingga melepaskan bradikinin dan serotonin. Jika terdapat penyumbatan pembuluh darah, akan terjadi iskemia dan penimbunan K + dan H + ekstrasel yang diakibatkan akan semakin mengaktifkan nosiseptor yang telah tersensitasi. Perangsangan nosiseptor melepaskan substansi peptide P (SP) dan peptide yang berhubungan dengan gen kalsitonin (CGRP), yang meningkatkan respon inflamasi dan menyebabkan vasodilatasi serta meningkatkan permeabilitas vaskular. Kata kunci : nyeri, nosiseptor ABSTRACTPain was a sensory and emotional experience of the unpleasant result of tissue damage, both actual and potential or described in terms of damage.The mechanism onset of pain was based on the multiple processes of nociception, peripheral sensitization, changes in phenotype, central sensitization, ectopic excitability, a structural reorganization, and decreased inhibition. Between stimulus and the subjective experience of tissue injury pain, there were four separate processes: tranduksi, transmission, modulation, and perception.Nosiseptor pain stimuli received by the skin and viscera. Necrotic cells that will release K + and intracellular proteins that can cause inflammation. Mediators cause pain to be released. Leukotrienes, prostatglandin E2, and histamine will sensitization nosiseptor besides tissue lesions also activate blood clotting thus releasing bradykinin and serotonin. If there was a blockage of blood vessels, ischemia will occur and the accumulation of K + and H + was caused by extracellular will increasingly enable nosiseptor have sensitization. Stimulation nosiseptor releasing peptide substance P (SP) and peptide calcitonin gene-related (CGRP), which increases the inflammatory response and cause vasodilation and increased vascular permeability.

Hubungan Derajat Kelainan Radiologik Dengan Derajat Nyeri Pada Penderita Osteoartritis Sendi Lutut Di Rumah Sakit Umum Daerah Kota Kendari

“…So this causes the release of chemical mediators such as prostaglandins and interleukins which in turn cause bone angina through the subchondral which is known to contain sensible nerve endings which can deliver pain because the tissue will release K + and intracellular protein. 6 The increase in extracellular K + levels will cause depolarization of nociceptors, while the protein in some circumstances will infiltrate microorganisms, causing inflammation. As a result, released pain mediators such as leukotriene, prostaglandin E2, and histamine will stimulate the nociceptors so that a transduction process occurs.…”

“…Pain-related neural signals and perceptual processes occur in the brain. 6 In the subchondral bone, repair occurs in the form of sclerosis, with increased bone activity and the formation of spurs at the joint edges, which can limit movement. The bone under the cartilage becomes hard and thick, and changes in the shape and fit of the joint surface.…”

“…If the damage continues then, the shape of the joint is irregular with joint space narrowing, osteophytes, instability and deformity. 6 With the formation of osteophytes, it will irritate the synovial membrane, where there are many pain receptors. It will cause hydrops 16,17 due to the exposure of polymodal nerve endings around the joints due to the formation of osteophytes that press the periosteum and nerve roots originating from the spinal cord.…”

“…The high prevalence of OA, which is chronic progressive in nature and causes joint pain, causes OA to have significant social and economic impacts, both in developed and developing countries. 6 According to the American College of Rheumatology, the diagnosis is based on knee pain and X-rays have found osteophytes and at least one sign and symptom from the age of more than 50 years, joint stiffness in the morning less than 30 minutes and crepitus found on physical examination. 6 Pain in these joints is usually the chief complaint that makes patients come to the doctor.…”

“…6 According to the American College of Rheumatology, the diagnosis is based on knee pain and X-rays have found osteophytes and at least one sign and symptom from the age of more than 50 years, joint stiffness in the morning less than 30 minutes and crepitus found on physical examination. 6 Pain in these joints is usually the chief complaint that makes patients come to the doctor. Genu osteoarthritis is the leading cause of morbidity, inhibition of physical activity and reduced quality of life for someone with osteoarthritis, especially in someone over 45 years of age, and osteoarthritis has a significant impact on social and economic life.…”