Herwin B.

Bautista Department of Anesthesia

 Pain

- an unpleasant sensory and emotional experience associated with actual or potential tissue damage Nociception - noci (harm or injury) - neural response to traumatic or noxious stimuli

 Nociceptive pain

- is due to activation or sensitization of nociceptors that transduce noxious stimuli

Neuropathic pain

- is the result of injury or acquired abnormalities of peripheral and central neural structures

 A. Acute pain

- caused by noxious stimulation due to injury, a disease process, or abnormal function of muscle or viscera - most common forms include posttraumatic, post operative and obstetrical pain, and with acute medical illnesses

 1. Somatic pain

a. superficial - skin subcutaneous tissues and mucuos membrane - well-localized, sharp, pricking throbbing, or burning sensation b. deep - muscles, joints, tendons, and bones - dull, aching quality and less localized

 2. Visceral pain

- acute pain due to disease process or abnormal function of an internal organ or its covering - subtypes; a. true localized visceral pain b. true localized parietal pain c. referred visceral pain d. referred parietal pain

 True visceral pain

- dull, diffuse, usually midline associated with abnormal sympathetic or parasympathetic response (vomiting, sweating, changes in CR and BP
True parietal pain

- sharp, stabbing sensation that is either localized around the organ or referred to other site

 B. Chronic pain

- pain persists beyond the usual course of an acute disease or after a reasonable time of healing - between 1 to 6 months - nociceptive, neuropathic or both - most common are musculoskeletal disorders, peripheral nerves, nerve roots and dorsal root ganglia

 Pain pathway