Medical Students

Pain Workbook

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Objectives

  • Define pain
  • Explore how it is classified
  • Refresh the physiology of nociception and pain
  • Review the pharmacological treatment of pain
  • Explore the notion of multimodal analgesia
  • Use RAT approach to manage pain

Prereading

Great presentation called Essential Pain Management by Wayne Morris and Roger Goucke

http://www.developinganaesthesia.org/essential-pain-management.html

QUESTIONS
(hint: see above website and your foundation term pain lecture notes)
1. What is pain? (IASP defn and simple defn)

2. Why should we treat pain? (Patient, family, society)

3. How does chronic pain differ from acute pain?

4. What 2 the other ways of classifying pain?

Answers to 3 and 4 are the 3 main questions that help us to broadly classify pain
5. What is nociceptive pain?

4. What is neuropathic pain?

5) Draw a diagram showing the pain pathway

6) What are the non-drug methods of treating pain, giving examples?

7. How do you recognize pain?

8. When assessing pain, what 3 aspects of pain are graded?

9. What are the 10 questions used to assess pain? (hint: severity, radiation….)

10a. What is the WHO Analgesic ladder and b. Define multimodal analgesia?

11. Complete this table

Differentials Dose Route Interval (reg/prn) Contraindications Important side effects
Paracetamol
Class______
Ibuprofen
Class______
Endone
Class______
Oxycontin
Class______
Morphine
Class______
Tramadol
Class______

12. List the common sides effects and lethal side effects of opioids? How can these risks be mitigated and treated (give medication names and doses)

Side Effect Minimise risk of side effect Treat side effect

 

13. When does a patient require a PCA?

14. When does a patient require an Acute Pain Service Referral?

15. What specialized techniques can be employed by anaesthetists to treat severe pain?

16. What is the sedation score?

  • 0
  • 1
  • 2
  • 3
  • S This may no longer be used at Western Health

17. For one patient from the pain round complete recognize/assess/treat management plan.

Recognize (how do you know they are in pain?)

Assess (Duration, cause, mechanism, severity – rest/movement/FAS)

Treat (non drug AND drug-what would you write on drug chart)

 

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